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The new version of the lead simply reintroduces all the old problems. Most of the current focus of the current lead is on relatively unimportant details that people can go to the body of the article to find out for specifics. Almost f the entirety of the changes were to minimize all mention of the controversy and hide it behind jargon that most people here will not understand.
While all DSM diagnoses are controversial, it is a bit disingenuous to claim that the controversy on this one doesn't need much space in the lead because of rampant controversy. The *kinds* of controversy and level of controversy between this diagnosis and others are quite a bit different. Very few people dispute schizophrenia exists at all or think that people who report symptoms are doing so because their therapist talked them into it.
From comments above I am not surprised that Mathew is whitewashing the article, but I am very disappointed in DocJames. To pretend that this isn't a more controversial diagnosis than most while at the same time provided a quot from a reliable source on the talk page to the contrary is really bizarre.
Unless these concerns are addressed I will revert back to the previous version. WP:NPOV policy is very clear on this. DreamGuy ( talk) 22:24, 29 July 2012 (UTC)
With respect to Wikipedia policy DreamGuy has support to revert to the previous version. One is not to start an edit war following this but to start a WP:RfC. Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 23:20, 29 July 2012 (UTC)
Question for Doc - What do we need to work on to make the current version something that is not bait for reversion? Give me a task and I am on it! ~ty ( talk) 00:46, 30 July 2012 (UTC)
Can we agree that this is a misleading statement that is currently in the lead? "Consensus is NOT lacking in the diagnosis and treatment of DID." I would think that the DSM-IV gives a consensus for a Dx of DID and the 2011 revised treatment guidelines ISSTD gives the guidelines for the treatment of DID. If this is not enough here is a [ http://psycnet.apa.org/psycinfo/2011-28153-001/ current review article by some major brains in the area of trauma and DID: Brand, Bethany L.; Myrick, Amie C.; Loewenstein, Richard J.; Classen, Catherine C.; Lanius, Ruth; McNary, Scot W.; Pain, Clare; Putnam, Frank W. . This review appears to agree with the 3 phase method already widely in use and suggested by the ISSTD. ~ty ( talk) 21:12, 29 July 2012 (UTC)
re controversy. I agree. I think all too much emphasis is placed on the controversy in the article (when controversy is endemic in psychology/psychiatry) and not enough on our lack of knowledge and the true confusion that surrounds this diagnosis and personality functioning in general. It's a much more interesting topic when explored as knowledge seekers than in taking sides over a controversy. MathewTownsend ( talk) 21:52, 29 July 2012 (UTC)
I am only addressing (for right now) the parts that were left in the lede before Dreamguys revert. Afterwards there is a host of errors to address!
Problem in the lede: http://www.ncbi.nlm.nih.gov/pubmed/18569730 It is ref #8 on the DID article This is a poor abstract that lays out a problem, then says what "the paper" will address. But no results or conclusions are reported.Research on treatment effectiveness always focuses on "clinical approaches", and at the beginning of a body of research the focus is always on case studies: "I took a client and did treatment X and here's what happened. Now we need a clinical study of a sample, etc." ~ty ( talk) 00:07, 30 July 2012 (UTC)
Another problem with the lede: "No systematic, empirically-supported approach exists." Kluft's report of over 200 of his cases yields a sustained full remission at 5 years after termination of treatment of ~85%. ~ty ( talk) 00:18, 30 July 2012 (UTC)
And another problem in the lede: "DID does not resolve spontaneously, and symptoms vary over time." What is the point of this sentence? Why is it in this paragraph? ~ty ( talk) 00:20, 30 July 2012 (UTC)
Another problem in the lede: "In general, the prognosis is poor, especially for those with co-morbid disorders." It is poor unless one gives appropriate treatment, a summary of which is detailed in Howell book.. Howell treatment model contains improvements: specific, proven therapy for trauma (something which Kluft says he always found necessary) - EMDR. So we might now reasonably assume that a treatment success rate of 85% is a lower limit of what good treatment would achieve. This makes treatment of DID more successful than the great majority of mental health disorders.
I am working on prognosis right now, but if anyone is doing cause, I found a good 2008 pubmed review article on DID. J Trauma Dissociation. 2008;9(2):249-67. Familial and social support as protective factors against the development of dissociative identity disorder. Korol S. ~ty ( talk) 03:12, 30 July 2012 (UTC)
I am working on this section here. I am reading a bunch on this, since of all the aspects of DID to study, this is the one that I have not looked into in depth, so this is interesting. Help is always greatly appreciated! ~ty ( talk) 13:27, 30 July 2012 (UTC)
This is what I have. Anyone have suggestions or changes for this? First is the text for the DID page, followed by support for the last sentence.
Generally, the earlier one is diagnosed the better the prognosis and even greater if diagnosis and treatment is obtained during childhood. Prognosis becomes far less optimistic if not appropriately treated. Successful treatment (psychotherapy) for adults usually takes years depending on ones goals; to operate as a unified self and free of the effects of DID or become coconscious, still having DID. If the typical 3 phase treatment for DID is completed, dissociative boundaries are reduced resulting in a unified self and elimination of the effects and symptoms of trauma memories. Therapy is not easy and hospitalization can be required for some patients. This chronic disorder rarely resolves spontaneously if ever. [2][3] [2] Individuals with primarily dissociative symptoms and features of post traumatic stress disorder normally recover with treatment. Many patients have a history of being sexually abused as a child and often cope by abusing alcohol or other substances - a negative way of coping with their victimization. Those with co-morbid addictions, personality, mood, or eating disorders face a longer, slower, and more complicated recovery process. Individuals still attached to abusers face the poorest prognosis; treatment may be long-term - and consist solely of symptom relief rather than integration. Changes in identity, loss of memory, and awaking in unexplained locations and situations often leads to chaotic personal lives. [3] Individuals with the condition commonly have histories of failed suicide attempts and self-harm. [4][5][6] ~ty ( talk) 16:22, 30 July 2012 (UTC)
It we could be more specific when it comes to referencing by adding the exact quote from the reference in question that would make things easier. Typically our paraphrasing should not be much different than the original. Here is a an example.
Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 21:08, 30 July 2012 (UTC)
DID treatment is supported by a body of prospective data in a well-defined population using valid and reliable measures of psychopathology.
Support for this statement
Summary of Ross and Halpern (2009): Ideally, treatment outcome studies are "...randomized, prospective, double-blind placebo-controlled.." designs. "Prospective" means we start with a condition, apply treatment, then see what happens. Most DID studies are retrospective - we're done with treatment, and we look back. This is important because retrospective studies do not have dropouts, a significant issue in proper studies.
Where DID is concerned, there are multiple essentially insurmountable hurdles here:
What this means is that there likely will not be a really good treatment outcome study for DID any time soon, if indeed ever. The hurdles are really big. Therefore, in the meantime acceptance of other studies if the norm.
Next, we look at treatment outcome studies in mental health. Here, they look only at medication. There is no mention of psychotherapy models other than theirs. This is a major flaw of their analysis, for a reason that may not be obvious. Basically, psychotherapy typically gets better results than do drugs. For many technical reasons Ross and Halpern (2009) summarize psychotropic medication, in general, as not especially effective. Reported successes are almost surely inflated due to inherent research design errors.
Moving to DID, Ross and Halpern (2009) comment that these "patients" are so complicated that they would simply be excluded from normal treatment studies, because: most have been psychiatric inpatients or have been suicidal, and most have other Axis I disorders including addictions. Such subjects just are not used in treatment studies - too many factors are in play to do a good study.
They then present treatment outcome data for participants in their treatment program in Texas.
My conclusion from the Ross and Halpern (2009) book: "The treatment techniques described in this manual are supported by a body of prospective data in a well-defined population using valid and reliable measures of psychopathology."
Never mind ~ty ( talk) 22:42, 30 July 2012 (UTC)
Traditionally dissociative disorders such as DID were attributed to trauma and other forms of stress that caused memory to separate or dissociate, among other symptoms, but research on this hypothesis has been characterized by poor methodology. So far, experimental studies, usually focusing on memory, have been few and the research has been inconclusive. [1] It became a popular diagnosis in the 1970s but it is unclear if the actual incidence of the disorder increased or only its popularity. An alternative hypotheses for its etiology is that DID is a product of techniques employed by some therapists.
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The section on epidemiology is full of primary research papers. Are there not secondary sources that give ranges for different populations? Once this section and the controversy surround prevalence has been improved here than a smaller summary can be added to the lead. My comments above on gender ratios belong here not in the lead. Belong in both spots maybe...
Doc James (
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Doc, I agree that we need to do the body first and the lead should be based upon the body. Unfortunately that's not what recent edits were doing. The gender disparity, for example, is interesting and definitely deserves a place in the body, but it got added the the lead right away and then tacked on to the body as an afterthought. Out of all the wide things that can be in the lead, something that was just tossed together and up to this point anyway showed no overall notability seems like an odd choice. And I say that as someone who put that back into the lead when reverting to the old consensus version because nobody objected to it. (As mentioned above, I think experts talking about why they think the gender disparity is there -- or if there are any studies on that specific topic somehow -- would be very valuable to the article, as compared to tossing it out there as a factoid.)
Recent discussions on the controversy suggested it shouldn't be there because there was no controversy section, which is missing the point entirely. The things mentioned in the lead that some people tried to remove (or reword so that it was incomprehensible to an average reader) are fully detailed in the body of the article in various places. They were being removed despite the fact that they accurately summarized the article. And we have discussion on this very talk page that explained all of that already, multiple times. It is incomprehensible how someone who was advocating editing the lead last was busy chopping it to pieces and adding wholly new material never before present in the article. DreamGuy ( talk) 02:34, 31 July 2012 (UTC)
I recommend working this up to GA status as this is then a consensus version that folks can refer back to when problems arise in the future. FA would be better but probably a tad ambitious..... Casliber ( talk · contribs) 00:51, 30 July 2012 (UTC)
While we do not typically have sections on controversy. Maybe in this article like for ADHD we should? We could put this text there?
DID is a controversial diagnosis. Supporters attribute the symptoms to the experience of pathological levels of stress, which they say disrupt normal functioning and force some memories, thoughts and aspects of personality from consciousness (dissociation); [1] [2] an alternative explanation is that belief in these dissociated identities is artificially caused by certain [[psychotherapy| psychotherapeutic]] practices and increased focus from the [[mass media| mass media]], leading the patients to imagine symptoms that did not exist prior to therapy. [3] [4] [5] [6] [7] [8] The debate between the two positions is characterized by intense disagreement. [3] [5] [6] [8] [9] [10]
Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 01:36, 30 July 2012 (UTC)
This is not what I meant. Thus I have moved the content that was moved in these edits [2] and [3]. Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 20:47, 30 July 2012 (UTC)
Please see Wikipedia:Criticism#Avoid_sections_and_articles_focusing_on_.22criticisms.22_or_.22controversies.22. DreamGuy ( talk) 01:51, 31 July 2012 (UTC)
Tylas reverted my edit with the summary "because we are working on it. Please be patient rather than reverting. Work with us - not against us please!" Tylas, I am part of that "we". The controversy is a very notable part of DID, probably far better known to most clinicians than the specifics of treatment. The body still contains considerable discussion of the controversy, and the lead should summarize the body. The version before my edits contained only two sentences on the controversy, with no indication of why DID is controversial, only that it is. The reasons can be summarized briefly, and in my opinion should be included. I'm not sure why you think my opinion should be casually discarded when it is quite in keeping with WP:LEAD. WLU (t) (c) Wikipedia's rules: simple/ complex 20:02, 30 July 2012 (UTC)
sorry, WLU, not sure what you are saying. There is a misunderstanding. Nothing in the article has been removed/added/changed because of the peer review. I started it to seek feedback from the people who do peer reviews. As you can see from the peer review page Wikipedia:Peer review/Dissociative identity disorder/archive1, there's been no responses. And I really don't expect any, given the topic. MathewTownsend ( talk) 21:12, 30 July 2012 (UTC)
I am unsure why this well supported content was removed? [4] and [5] One set of text was supported by major textbooks and the other by a 2011 review article (PMID:2182904) Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 20:51, 30 July 2012 (UTC)
If we simple use recent secondary sources and give similar weight that they give we should be good. Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 23:53, 30 July 2012 (UTC)
What somehow appeared in the lede today: It became a popular diagnosis in the 1970s but it is unclear if the actual incidence of the disorder increased or only its popularity. An alternative hypotheses for its etiology is that DID is a product of techniques employed by some therapists and disagreements between the two positions is characterized by bitter debate.[11][12][13][14][3][15] Critics of the diagnosis point to characteristics such as the rareness of the diagnosis before 1980, the lack of children with DID, vagueness of the diagnostic criteria and terminology, changes in the number and forms of patient alters and the clustering of the diagnosis around certain clinical groups as evidence that the condition is due to social role-play rather than a true mental illness.[15][16]
This is a mess, a long paragraph with [11][12][13][14][3][15] all this to try and give credit to one sentence. The problem is that probably most of this stuff was taken out of context. If you are going to say there is "bitter debate" then you need to say about what exactly, not just give a long list of papers that might have similar words, that actually mean totally different than what you are implying. The Text book Doc James posted answers all these claims (I think all quite actually), but to go back and forth on all this would make the article long and boorish and still never tell people what DID is. This is just old boring stuff. What is interesting is what is real and now understood.
Critics of the diagnosis point to characteristics such as the rareness of the diagnosis before 1980, the lack of children with DID, vagueness of the diagnostic criteria and terminology, changes in the number and forms of patient alters and the clustering of the diagnosis around certain clinical groups as evidence that the condition is due to social role-play rather than a true mental illness.[15][16] This is just more of the same ~ty ( talk) 23:41, 30 July 2012 (UTC)
While adding footnotes is helpful, adding too many can cause citation clutter, which can make articles look untidy in read mode, and unreadable in edit mode. If a page has extra citations that are either mirror pages or just parrot the other sources, they contribute nothing to its reliability while acting as a detriment to its readability. One cause of "citation overkill" is edit warring, which can lead to examples such as "Garphism is the study[1][2][3][4][5] of ...". Extreme cases have seen fifteen or more footnotes after a single word, as an editor desperately tries to shore up his point and/or overall notability of the subject with extra citations, in the hope that his opponents will accept that there are reliable sources for his edit.
One cause of "citation overkill" is edit warring, which can lead to examples such as "Garphism is the study[1][2][3][4][5] of ...".
Someone has updated the recommendations on citations in the lead to mach with reality :-) [6] Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 03:27, 31 July 2012 (UTC)
I noticed in the signs and symptoms section this was written: "Despite research on DID including structural and functional magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, event-related potential and electroencephalography, no convergent neuroimaging findings have been identified regarding DID..."
But then the last sentence of the same paragraph states, "DID patients may also demonstrate altered neuroanatomy."
This seems confusing and contradictory to me.
(Sorry if I'm just misunderstanding or going about things the wrong way; I'm new here.) Dirajero ( talk) 00:24, 31 July 2012 (UTC)
Everyone is talking every which way and making large numbers of edits to the article, and very few of these changes are being discussed. Even fewer are receiving anything like a wide agreement.
On controversial topics, the goal of NPOV policy is not that everyone is happy, but that everyone (or as many people as possible) agree that the wording that exists is fair and accurate. Many of the recent edits have been in areas that anyone looking at this topic page would know were already discussed as unfairly slanted and inaccurate. We all know this is a very controversial article. Nobody can in good conscience ignore that. To ignore that and rush ahead suggests you are not interested in working with others. It shows bad faith in your edits here. I know people are emotional, but everyone needs to follow our policies. I can understand why newbies might make this mistake, but for editors who have been around a long time it's incomprehensible.
Per WP:BRD, I have reverted to the last stable version. DocJames above said I had every right to do so in this situation, so I did. This version is the version closest to the one that had consensus for many months here, other than a few changes made to fit what everyone I've seen so far agreed on (removing mention of Sybil, though I did so reluctantly until we have better wording we can agree upon) DreamGuy ( talk) 02:17, 31 July 2012 (UTC)
Your latest addition ("Disturbed and altered sleep has also been suggested as having a role in dissociative disorders in general and DID in specific. [11]" is very interesting. Now that I've been looking at the recent literature, I see that the research has turned toward examining the memory functioning from a neurological view, examining avenues like altered sleep etc. Since psychiatry in general is leaning more toward genetic and neurobiological influences, it makes sense that if the field would drop this dichotomy of real versus play acting and start actually examining what is going on, it could get really interesting! Thanks! MathewTownsend ( talk) 02:36, 31 July 2012 (UTC)
This is a great new section. I am going to do some more reading on this. Thanks to whoever added it! ~ty ( talk) 00:22, 1 August 2012 (UTC)
Wikipedia has no deadline per WP:NODEADLINE. No one person should write this article and no one should be making big changes in one day. This article is a collaboration. Many of your problems come from doing too much too fast. Slow down! This article is about a diagnosis, not about anyone's personal experience. MathewTownsend ( talk) 01:11, 1 August 2012 (UTC)
Under "Signs and symptoms" where it says: "The majority of patients with DID report a history of abuse, both sexual and physical during their childhood." I edited out the phrase "resulting in feelings of shame and fear that might inhibit reporting symptoms." This is no different from any individuals who have a "history of abuse, both sexual and physical during their childhood", so this is not characteristic of those diagnosed with DID. I hesitated about the inclusion of "Individuals with DID may experience distress from the consequences of DID rather than from the symptoms themselves." It is cited to an article recommending future directions for DSM-V - but since I don't have access to the whole article, I don't know what empirical evidence Spiegel is basing this on. MathewTownsend ( talk) 23:43, 1 August 2012 (UTC)
Hales-prognosis - quote=Furthermore, because most patients with DID report histories of sexual and physical abuse, the shame associated with that experience, as well as fear of retribution, may inhibit reporting of symptoms.
See page 683 - under the title "Course" on the right side of the page - it is a little less than halfway down that column. Also I have no idea why it has a citation of Spiegel. I did not do that. ~ty ( talk) 00:09, 2 August 2012 (UTC)
If you don't know how to add a quote to a citation template, ask. I don't see the need for a large number of quotes anyway, the points that are having quotes added to them are not being challenged that I can see, nor are they so fine or nuanced that they need a direct quotation to avoid misrepresentation. Quotes add to the length of the page (and the page is already quite long), and for the most part do not add to the interpretation. If the text says "DID rarely if ever goes away without treatment", I do not see a need for a quote saying "but dissociative identity disorder does not resolve spontaneously". WLU (t) (c) Wikipedia's rules: simple/ complex 21:54, 31 July 2012 (UTC)
Patients are often hesitant to complete psychotherapy due to fear and shame from the abuse suffered in their childhood
Furthermore, because most patients with DID report histories of sexual and physical abuse, the shame associated with that experience, as well as fear of retribution, may inhibit reporting of symptoms
Resolution of symptoms of DID is important to more than just the DID patient but to the well-being of off-spring as well. Parenting is quite difficult for the person with DID, even though it might not be obvious to them, severe dissociation and other actions affects their children
One last consequence of DID is the subject's inability to be adequate parents, at least while symptomatic
I agree with WLU. Quotes are not needed, indeed they clutter the text, unless it is an unusual or unlikely statement. Also, it's not good to cite the same source over and over per WP:UNDUE. No one authority needs to be used as a source more than a few times. MathewTownsend ( talk) 00:18, 1 August 2012 (UTC)
Please Tylas, the prognosis section is not solely your responsibility. Best to add a little now and then per day, while keeping the balance of the entire article in mind. Then reflect on the whole and read more sources. IMO, there isn't a whole lot to say about prognosis as there are few reliable secondary sources that address the subject, especially review articles. For example, the statement: "Prognosis can be excellent; case studies report that most cases of DID resolve with proper therapy, but there are no controlled trials." This sentence gives us little useful information as case studies by their nature are not valid for outcome statements. And they are usually written by proponents of the therapy who are going to report favorable outcomes and therefore are not NPOV. No controlled trials means we have no information on prognosis. MathewTownsend ( talk) 13:25, 1 August 2012 (UTC)
A good way to start is to read the article and make little copy editing changes, like spelling etc. Then, since this is a controversial article, why don't you discuss any proposed changes on the talk page first. Then, make a few small changes and see how they are received by other editors. No one should be putting such a large amount of text that if it's deleted they can't handle it. (And remember, anything you write is still in the article history and can be retrieved.) If someone makes a deletion you disagree with, take it to the talk page and discuss it. Remember, other editors, like WLU, have worked long and hard on this page over a period of years so think how they are going to react when you make many major changes to the article without consulting others in a few days. MathewTownsend ( talk) 16:13, 1 August 2012 (UTC)
Using the word "personality" simply continues to confuse people about not only DID, but basic psychology. I refer you back to my section titled Psychology 101 which explains this. I will look for it on the talk page. It might have been archived. 21:42, 2 August 2012 (UTC) ~ty ( talk) 21:46, 2 August 2012 (UTC)
"Despite the lengthy history of the psychopathology of dissociative disorders, and the intense study by Pierre Janet in the first part of the last century and by Jean-Martin Charcot before him, dissociative disorders have been largely disregarded since Freud and have not received serious attention again until recently.[45] Prior versions of DSM have avoided consideration of etiology in an effort to distance itself from Freudian psychology. DSM-V is attempting to reintroduce etiology; and the "development of a pathophysiologically based classification system" has been advocated such as investigation of the neuroevolution of "stress-induced and fear circuitry disorders and related amygdala-driven, species-atypical fear behaviors of clinical severity in adult humans."[46]"
I just read this. Wow! Now that is someone that understands what is going on both with history and the DSM. Thank you to whoever did this. It's a breath of fresh air! I think advocated is spelled wrong. Will fix for you. :) ~ty ( talk) 01:08, 1 August 2012 (UTC)
Because it hasn't happened yet and when it is published it may not reflect the published proposals. It is not part of the diagnosis now, which is what this article is about. And Casliber is a psychiatrist, and he thinks its inappropriate to include it. (And I agree with him.) He wrote Major depressive disorder which you might take a look at as a model for how an article on a psychiatric diagnosis should be formatted. MathewTownsend ( talk) 21:33, 2 August 2012 (UTC)
What (Spiegel D, Loewenstein RJ, Lewis-Fernández R, Sar V, Simeon D, Vermetten E, Cardeña E, Dell PF.) say about DID in this review article is that:
3. The diagnostic criteria for DID should be changed to emphasize the disruptive nature of the dissociation and amnesia for everyday as well as traumatic events. The experience of possession should be included in the definition of identity disruption.
There is a growing body of evidence linking the dissociative disorders to a trauma history, and to specific neural mechanisms. ~ty ( talk) 01:04, 2 August 2012 (UTC)
Here is a great review article on dissociation by David Spiegel MD. In the article it says there is controversy about what dissociation is. This article should help with that. ~ty ( talk) 18:15, 2 August 2012 (UTC)
I was bold and removed the DSM-V section per Casliber above. I believe there are compelling reasons not to include it, aside from the fact that it is not a final version. It only adds more complex terminology to the article without clarifying anything. MathewTownsend ( talk) 19:47, 2 August 2012 (UTC)
Can those who have been editing please archive threads which are resolved or repeated elsewhere. Also, if good sources have been found, can someone note that they've been added. I've just started to read this talk page and am trying to figure out where to start..... Casliber ( talk · contribs) 12:44, 2 August 2012 (UTC)
The next step is to look at Medical article guidelines and Good Article guidelines and see how the article squares up. I agree that Peer Review is generally a good idea, though I worry that it will fork discussion into two places..... Casliber ( talk · contribs) 12:44, 2 August 2012 (UTC)
There is "considerable delay between initial symptoms" and the time DID "emerges." Usually DID does not "emerge" before adolescence. name=Hales-prognosis>"Course". p. 283. {{
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Does anyone argue this change?
~ty (
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I am confused. The WP article says "To date approximately 250 cases of DID in children have been identified, though the data does not offer unequivocal support for either theory.", but the reference I look at (and I want to read the entire article, but there is only an abstract there says: "The review produced a total of 255 cases of childhood DID reported as individual case studies" The WP statement makes it sound like there have only been about 250 cases ever of diagnosed DID. Is this right? I must admit, I have not dug much into childhood DID. ~ty ( talk) 00:39, 2 August 2012 (UTC)
Here is the article: RESULTS:
The review produced a total of 255 cases of childhood DID reported as individual case studies (44) or aggregated into empirical studies (211). Nearly all cases (93%) emerged from samples of children in treatment, and multiple personalities was the presenting problem in 23% of the case studies. Four US research groups accounted for 65% of all 255 cases. Diagnostic methods typically included clinical evaluation based on Diagnostic and Statistical Manual of Mental Disorder criteria, but hypnosis, structured interviews, and multiple raters were rarely used in diagnoses.
CONCLUSION:
Despite continuing research on the related concepts of trauma and dissociation, childhood DID itself appears to be an extremely rare phenomenon that few researchers have studied in depth. Nearly all of the research that does exist on childhood DID is from the 1980s and 1990s and does not resolve the ongoing controversies surrounding the disorder. ~ty ( talk) 01:32, 2 August 2012 (UTC)
O-kay - I can't see the google book pages but have a word of caution to add. One interpretation is that identities are an extreme expression of a normal human phenomenon. Children from the age of two might pretend to be a dog or a cat and get really overinvolved. Young children have quite different reality-testing to adults. Adults don't adopt personas per se but do act differently and pervasively depending on the role they are in, hence a doctor, lawyer, rock musician will have a different selection of behaviours if they are in their job role, with friends, or family etc. Anyway this is getting off topic but I'll try and take a look at the research. Casliber ( talk · contribs) 13:07, 2 August 2012 (UTC)
In this edit the key point that "Prognosis when untreated, is poorly understood" was removed with the inaccurate summary of "add back another part" [8]. This has now occurred a number of times and I have replaced it again. Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 17:38, 2 August 2012 (UTC)
If a reference mentions a certain point, but the point of the reference is to disagree with what that point, should it be used as a reference to support the subject it is arguing against? One example below?
Therapist induced - header
Please don't cut and paste citations as you did above. Put clickable sources in your statement. The cut-and-paste numbers will change if someone adds another citation. And it makes it hard to figure out what you're saying since I have to go back and forth from your cut-and-paste to the article. MathewTownsend ( talk) 15:38, 4 August 2012 (UTC)
Interesting points Mathew. WLU, I was not looking to replace the iatrogenic stuff, I was just wondering if that was a good source to use, but since you bring it up, there are lots of references out there that could be used to show that iatrogenic and trauma/DA are not equal. Doing a quick search of reviews, here is the first one I found:
* Abstract "The incidence of dissociative identity disorder (DID) is strongly correlated with exposure to serious physical and sexual abuse. Although studies of more than 1,000 DID sufferers indicate that severe child abuse is a predisposing factor in 95% to 98% of cases (B. Braun, 1988), abuse alone is not, in fact, predictive of DID (B. Rind & P. Tromovitch, 1997). Disorganized/disoriented attachment style and the absence of social and familial support, in combination with abuse history, best predict DID (D. Howe, 2006; R. Kluft, 1984; K. Lyons-Ruth, L. Dutra, M. Schuder, & I. Bianchi, 2006)."
I am going to add this information to the trauma section, when I have a moment. Any objections before I do? It is a review article and it is newer. ~ty ( talk) 04:58, 5 August 2012 (UTC)
As far as I can tell I've consolidated all the references so there is no more duplication of sources. WLU (t) (c) Wikipedia's rules: simple/ complex 02:40, 5 August 2012 (UTC)
If it is, it counters some of the claims in the WP article. Here are a couple of examples:
Look at the references they list for the Medline article. Only a few deal with DID. Most refer generally to "dissociation" if they mention it at all. Many are on child abuse without mentioning dissociation. Many are on PTSD. Most are primary research. Many were done in the 1980s and 1990s. The article seems to confuse DID, dissociation, PTSD. There is a huge concentration on studies of child abuse but they don't have solid review articles linking it to DID. Many other problems with the references.
Look for yourself:
MathewTownsend ( talk) 02:03, 5 August 2012 (UTC)
Article authors: Contributor Information and Disclosures Author
Muhammad Waseem, MD Associate Professor of Emergency Medicine in Clinical Pediatrics, Weill Medical College of Cornell University; Consulting Staff, Department of Pediatrics, Bronx Lebanon Hospital; Consulting Staff, Department of Emergency Medicine, Lincoln Medical and Mental Health Center
Muhammad Waseem, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Heart Association, and American Medical Association
Disclosure: Nothing to disclose. Coauthor(s)
Muhammad Aslam, MD Instructor in Pediatrics, Harvard Medical School; Staff Physician, Department of Medicine, Division of Newborn Medicine, Children's Hospital Boston
Muhammad Aslam, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Medical Association, Massachusetts Medical Society, and Southern Medical Association
Disclosure: Nothing to disclose.
Richard M Switzer, Jr, MD Consulting Staff, Department of Pediatrics, Brooklyn Hospital Center
Richard M Switzer, Jr, MD is a member of the following medical societies: American Academy of Pediatrics and American Medical Association
Disclosure: Nothing to disclose.
Orlando Perales, MD Associate Director of Pediatric Emergency Services, Department of Emergency Medicine, Lincoln Medical and Mental Health Center
Orlando Perales, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose. Specialty Editor Board
Carol Diane Berkowitz, MD Executive Vice Chair, Department of Pediatrics, Professor, Harbor-University of California at Los Angeles Medical Center
Carol Diane Berkowitz, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, American College of Emergency Physicians, American Medical Association, American Pediatric Society, and North American Society for Pediatric and Adolescent Gynecology
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Caroly Pataki, MD Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.
Carrie Sylvester, MD, MPH Senior Child and Adolescent Psychiatrist, Sound Mental Health
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry
Disclosure: Nothing to disclose. Chief Editor
Caroly Pataki, MD Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.
~ty (
talk) 19:45, 6 August 2012 (UTC)
No. Because the articles are out of date, and almost none of those articles indicate that the author is familiar with DID. (Remember "dissociation" or "dissociative disorders" are not the same as DID.) Besides, lots of disorders have a high past history reported of child abuse. (Schizophrenia and Borderline personality, for example. And the field has changed a lot since the 1980s and 1990s) Please read WP:MEDRS. MathewTownsend ( talk) 20:09, 6 August 2012 (UTC)
I removed the following text from the prognosis section:
Changes in identity, loss of memory, and loss of time often lead to chaotic personal lives, since it is common for highly dissociated "personality states" to not know what other "personality states" know due to the amnestic barrier between those "personality states". Psychotherapy for adults usually takes years depending on the patients goal. Unifying or "integrating" the various "dissociated states" of the "personality" is considered best for the patient allowing them to finally operate as a unified "personality" and to have freedom of the crippling effects of DID. Some patients however, for personal reasons, cannot bring themselves to do this, instead they opt to obtain an acceptable level of coconscious, still retaining their dissociated "personality states", but with reduced amnesic barriers.
Prognosis is about the clinical course of a patient. Most of these are symptoms, which is why I moved them to the symptoms section. What isn't a symptom is mostly material for the treatment section, though I've retained the bit about duration and goals of treatment.
Also, Tylas, you do not understand how a ref name tag works. The whole point of a ref name tag is to have a single citation that can be used multiple times. That means there is only one ref name tag with a citation attached, not a series of ref name tags each with a quote attached. If you really feel the need to append a quote next to a citation, I suggest using invisible text, but as I've said before - the quotes are only useful if someone is contesting the material and you're better off just discussing that particular summary and quote than appending it to the text (particularly in a form that doesn't actually display in the footnotes). WLU (t) (c) Wikipedia's rules: simple/ complex 01:52, 5 August 2012 (UTC)
I can't find the section even in the archives, but this is the idea of why using the term personality is confusing to most. Again, I agree with Matthew that personality states is a good idea.
F. Putnuam reported back in 1977 that no "personality state" is an "original part." There is no original part. A persons sense of self is "built up and synthesized over time. E. Howell (2011) adds to this that "the usually presenting part is, by definition, a part in relation to and in relationship with other parts in the total organization of the personality. Current research in neurobiology, cognitive psychology, and developmental psychology indicates that the brain, the mind, and the self are normally multiple. The brain is organized into "neural system" - these systems "function independently. So, no one is born with one unified self (personality). During infancy, behavior is organized as a set of discrete behavioral states (such as deep sleep, awakening, eating) which link and group together in sequences over time. For the natural process of integration to proceed correctly, a child must attach to at least one of their primary caregivers. All people have multiple states or parts of the personality - these parts are called ego states. In the healthy mind, a person can switch from ego state to ego state, which is a smooth process that goes without much notice. Once you understand how the normal process works, then understanding DID is much easier. With the information above in mind, now consider how forming a unitary self can deviate from the norm and cause a major dissociative disorder such as DID. Natural integration which normally occurs during childhood does not take place for whatever reasons. The cohesive self (with it's many ego states) is not formed. Instead of ego states dissociated states (parts) or alters are created.
So, to avoid confusion by readers, I request that we use the term "personality states" rather than "personality." ~ty ( talk) 22:06, 2 August 2012 (UTC)
To WLU - As you have provided many an example that either someone answers you with a satisfactory answer or you do as you want in the article, I demand an answer here or will assume you cannot find one and in that case for this article we need to assume that this controversy you want to push so much is not equal to the mainstream consensus of trauma and DA. You have avoided the direct question so far, yet have continued to delete every single edit I have made. Please answer with direct references to support your POV. ~ty ( talk) 15:33, 5 August 2012 (UTC)
"The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self)." I think this is as close as we can come to a definition of "personality states".
MathewTownsend ( talk) 17:43, 3 August 2012 (UTC)
I agree, we should inform people that there's debate over the terminology, including personality versus personality state.
Also, the mainstream consensus is not "DID is trauma based". That is the consensus at the J Trauma Dissociation, but it's not universal. Merck is one source, an overview source, but it is not the only source. There is genuine, significant debate about DID in the literature, and the page should reflect this. WLU (t) (c) Wikipedia's rules: simple/ complex 13:46, 4 August 2012 (UTC)
The Iatrogenic position is not a significant controversy to warrant more than one controversy section on the WP DID page - which I do strongly feel should be presented. I am bringing this important question to the forefront of discussion, since it is the point of controversy on this page (but not in the real world) and the question keeps getting shoved aside. I asked WLU a direct question which he has not yet answered - other than to give his own POV. I will ask it again below.
I have asked WLU for current references that say that the iatrogenic position is a mainstream consensus of DID, but I only get his personal opinion on it. As WLU often does, I must demand his next work on this page should be to supply such references.
On the otherhand, it is cited over and over again, in text books, on medical sites and in research that THE mainstream consensus is that childhood trauma (and DA) is the cause of DID. ~ty ( talk) 14:53, 6 August 2012 (UTC)
To Tylas
Please listen to Doc James! The causes of all psychiatric disorders is unknown. All proposed "theories" are tentative. The "schizophrenogenic mother" used to be blamed for schizophrenia; now we think it's primarily an inherited predisposition. What someone (even an expert) thought in 1984 about child abuse and "multiple personality" is not necessarily what we think today. Knowledge is not "fixed". That's why we must concentrate on recent research and recent thinking. Consider that we can't define "dissociation" today, or even "personality"! The field is rapidly changing -- very rapidly.
When so many children get abused, why do only some become DID? There are too many unanswered questions to push a particular "cause" of DID. Please lets explore the possibilities as set forth in the literature, and not push one point of view or another. I think more research on the workings of "memory" and examination of "normal dissociation" which we all engage in every day is needed. After all, the concept "personality" is only a model. Maybe we all are "multiple personalities" in one way or another. We all recognize that "memory" can often be false. (Mine certainly can be.) — Preceding unsigned comment added by MathewTownsend ( talk • contribs) 19:15, 7 August 2012 (UTC)
Reply to Mathew: Also please note that I do agree that the 1980's psychology was a mess! It is 2012 now though. Also we can define dissociation! Saying that DID is caused from watching TV and reading a book is nuts. The false memory battle has nothing to do with DID and should not even be dragged into the conversation. Yes, we all have multiple parts to our one personality. DID has little to do with repressed memories of child sexual abuse - in DID dissociated states hold the memories, but trying to remember the abuse is not a goal of therapy in DID! Breaking down the dissociative barriers is! What you wrote is not what DID is about! Those with DID have horrendous symptoms that they need to deal with and it has been shown that proper therapy can correct the problem. Not to discount those that suffered sexual abuse as a child, but this is not the same as DID - those children achieve NORMAL childhood integration and probably do not have disorganized attachment problems! This is not the same as DID or even DDNOS or Complex PTSD. I don't know how to better explain this, but false memory ideas should not be addressed here. This is not a concern having to do with DID at all!
There is valid evidence of therapists creating temporary dissociative personality states and I totally believe this should be included in the DID article. I don't know of any expert in the DID area that does not agree with this. At the same time, this type of therapy is no longer used by any ethical practicing therapist today. ~ty ( talk) 21:49, 7 August 2012 (UTC)
I am glad you asked the questions, but this is not pushing a particular cause of DID! This is what the experts in the field of trauma, the consensus of the EXPERTS think. It is all but a small fringe group that thinks this. Mathew - I thought you were a therapist? You were talking about renewing your CE credits? I am confused. Anyway ---- here is mainstream consensus on how the personality forms, what an ego state is and why only some that are severely abused throughout their entire childhood get DID. ~ty ( talk) 21:17, 7 August 2012 (UTC)
Right now the page uses the 5th edition of Adult Psychopathology and Diagnosis 15 times. I just found out that a 6th edition was printed in 2012, with a completely different set of authors writing the chapter on dissociative disorders (Steven Lynn, Joanna Berg, Scott Lilienfeld, Harald Merckelbach, Timo Giesbrecht, Michelle Accardi and Colleen Cleere, see chapter title page [9]). I'm trying to get my hands on a physical copy of the book because google books preview is of the Kindle edition or something, and is harder to link to specific pages. This is a pretty dramatic switch in authorship, as Cardena was far more in the traumagenic camp, while Lynn et al. are mostly authors in the sociocognitive camp. This is a bit of a weird case, both are reliable sources, both represent very different points of view, and I'm expecting the chapters to be substantially different in emphasis, content and criticality. I'm not actually sure what to do - should all the 5th edition references be replaced, can the 5th edition still be used, can we have "competing chapters" used to cite both sides of an issue? I haven't read the chapter yet so all this is somewhat premature, but I do expect this to have a pretty significant impact on the page so - heads' up! WLU (t) (c) Wikipedia's rules: simple/ complex 19:05, 7 August 2012 (UTC)
DID is a valid psychological diagnosis, a mental disorder that is included in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) and the proposed DSM 5 - a serious mental disorder which is at least as common as Schizophrenia. According to the mainstream consensus in psychology today the trauma model is the best model we have and it explains that the sense of self is "built up and synthesized over time. E. Howell adds to this that "the usually presenting part is, by definition, a part in relation to and in relationship with other parts in the total organization of the personality. Today's research in neurobiology, cognitive psychology, and developmental psychology indicates that the brain, the mind, and the self are normally multiple. The brain is organized into "neural system" - these systems "function independently.
Once you understand how the normal process works, then understanding DID is much easier. With the information above in mind, now consider how forming a unitary self can deviate from the norm and cause a major dissociative disorder such as DID.
1. A baby/toddler does not achieve normal attachment due to severe neglect and severe and constant abuse during the earliest years of life. The same baby/toddler cannot achieve normal integration, again due to severe neglect and abuse. The integration should have happened naturally during the earliest years of life but due to trauma it did not happen.
2. Abuse continues throughout this child's life, a child who never achieved normal integration and is suffers from disorganized attachment. This child can become more fragmented.
Though the vast majority of DID cases are caused by child abuse and neglect (by a child's caretakers) this is not always the case. There are accidental ways a child can experience the early childhood trauma of an abused child - such as hospitilazation, an accident, a death, etc..., but still the cause is trauma.
Check list for DID:
Stress and lack of social support from a primary caregiver is experienced in infancy and continues throughout the early years in those with DID. Children have an innate ability to cope using dissociation and are often able to dissociate memories and experiences from consciousness. These memories and feelings they buried - so to say, are later experienced as a separate entity; if the process is repeated numerous times, multiple parts of the self (dissociated parts) may be created.
Does it make sense now? ~ty ( talk) 21:17, 7 August 2012 (UTC)
Thank you also for continuing to work on our article on DID. However, the study you reference above [11] is a primary source. Please try to follow WP:MEDRS in providing sources, else even the "basics" are not supported. It can't be assumed that the reader knows the "basics" of DID. Also, the definition of DDNOS is incorrect according to the DSM. It isn't a category for those who have have achieved "some normal integration has taken place ..." MathewTownsend ( talk) 13:37, 9 August 2012 (UTC)
Making my argument more clear: Sorry, I did not present this information correctly late last night. I was in a fog of exhaustion. Let me restate: Information from the ISSTD should be used for the WP DID article because many of the authorities in the field are members and in the past information from the ISSTD has not been allow on the WP DID page which is a clear instance of anti-expert bias. My point is that information from the ISSTD should be allowed to be used on the WP DID page. ~ty ( talk) 14:47, 9 August 2012 (UTC)
Please don't go back and edit your comments once others have responded to them, per editing your own comments. It leaves a misleading impression. Readers coming later don't understand all the rewording and deleting you've done, so they won't understand the responses that follow. MathewTownsend ( talk) 18:02, 9 August 2012 (UTC)
I don't see the applicability of the Rind et al. controversy here, as far as I can remember none of the articles touched on DID even tangentially. Correct me if I'm wrong. In any case, though it's part of the overall constellation of memory, abuse and dissociation, the current discussion doesn't make the connection clear. WLU (t) (c) Wikipedia's rules: simple/ complex 13:12, 9 August 2012 (UTC)
“ | Psychotherapists of all people should welcome further evidence of human resilience. But the religious conservatives who hated the message of the Rind et al. study quickly found support from a group of clinicians who still maintain that childhood sexual abuse causes everything from eating disorders to depression to "multiple personality disorder"; and if depressed adults cannot remember having been sexually abused in childhood, that's all the more evidence that they "repressed" the memory. These ideas have been as discredited by research as the belief that homosexuality is a mental illness or a chosen "lifestyle," but their promulgators cannot let them go. These clinicians want to kill the Rind study because they fear that it will be used to support malpractice claims against their fellow therapists.
Indeed, a group of them, whose members read like a "Who's Who" in the multiple personality disorder and recovered-memories business, made this fear explicit in a memo to the CEO of the American Psychological Association: "In addition to the fact that we, as a group, wish to protect the integrity of psychotherapy, we also want to protect good psychotherapists from attack and from financial ruin as a result of suits that are costly both financially and emotionally." To a casual observer, this concern is a non sequitur; what in the world does a meta-analysis on the long-term effects of childhood sexual abuse have to do with the practice of psychotherapy? Good therapy is still helpful for children and adults suffering from traumatic experiences. But bad therapy, such as that based on unvalidated assumptions that sexual experiences in childhood are invariably traumatizing and commonly "repressed," might indeed be in jeopardy from the meta-analysis. Isn't that important news, especially for "good psychotherapists"? |
” |
"there is no actual research that shows that the complex phenomenology of DID can be created, let alone sustained over time, by suggestion, contagion or hypnosis. Reference: International Society for the Study of Trauma and Dissociation (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, third revision. Journal of Trauma & Dissociation. 12:2, p. 124 Please note the HUGE list of respected researchers in the field of DID that have contributed to this 2011 work and that it is your reference #6 at the moment. ~ty ( talk) 13:49, 12 August 2012 (UTC)
This current DID WP page is adding to that confusion presented in the above paragraph. "The difficulties in diagnosing DD result primary from lack of eduction among clinicians about dissociation, DD and the effects of psychological trauma, as well as from clinician bias." Reference: International Society for the Study of Trauma and Dissociation (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, third revision. Journal of Trauma & Dissociation. 12:2, p. 117 Please note the HUGE list of respected researchers in the field of DID that have contributed to this 2011 work. ~ty ( talk) 15:16, 12 August 2012 (UTC)
A Solution to the problem - Why not simply keep this article as the mainstream consensus article and make another that shows the minority POVs? That page can be linked to from this page. WP in an encyclopedia and as such should not be adding to confusion about DID, however for those interested in controversy, there should by all means be a page about it. Per WP guidelines - "The article on the Earth does not directly mention modern support for the Flat Earth concept, the view of a distinct minority; to do so would give undue weight to the Flat Earth belief.
~ty (
talk) 20:10, 13 August 2012 (UTC)
Tylas, have you read WP:NPOV? "Editing from a neutral point of view (NPOV) means representing fairly, proportionately, and as far as possible without bias, all significant views that have been published by reliable sources."
You seem to be suggesting a POV fork, also forbidden by WP:NPOV: "A POV fork is an attempt to evade the neutrality policy by creating a new article about a subject that is already treated in an article, often to avoid or highlight negative or positive viewpoints or facts. POV forks are not permitted in Wikipedia." MathewTownsend ( talk) 20:34, 13 August 2012 (UTC)
The link you give above " Here is the link ( pubmed link) to the new study", is not to a new study but merely to a comment (i.e. opinion) given in response to Boysen's review article. Therefore, it does not meet the requirements of WP:MEDRS. Please read and learn what the requirements are for a reliable source for a medical article and save us all a bunch of trouble. MathewTownsend ( talk) 23:20, 13 August 2012 (UTC)
Reply to Mathew - Sir, I had to back up here. The entire point of this discussion has been lost and we are debating things that were not even questioned. The topic was the question: is the sociocongnitive POV a fringe or minority POV. Where did we even discuss DDNOS and what does this have to do with what we are talking about? I know quite well what DDNOS, particularly DDNOS-1, but where was this even mentioned on this talk page? I offered a great 2012 source written by (Chu, Dell, van der Hart, Cardena, Barach, Somer, Loewenstein, Brand, Golston, Courtois, Bowman, Classen, Dorahy, Sar, Gelinas, Fine, Paulsen, Kluft, Dalenbert, Jacobson-Ley, Nijenhuis, Boon, Chefetz, Middleton, Ross, Howell, Goodwin, Coons, Frankel, Steele, Gold, Gast, Young and Twomby.) and in return have received the 3 articles we are talking about: review on children does not answer the question: is the sociocognitive POV a minority or fringe POV - especially when the author Boysen did not take either side of the argument and the other 2 papers are historic. ~ty ( talk) 00:46, 14 August 2012 (UTC)
The 166th APA Annual Meeting in San Francisco, May 18-22, 2013, will mark the official release of DSM-5. DID in the DSM 5 This is just an update of the update. :) ~ty ( talk) 23:49, 14 August 2012 (UTC)
Full free pdf online: International Society for the Study of Trauma and Dissociation (2011). The full pdf is online for free by going to this page and clicking on the orange link - about the middle of the page: Open a copy of the 2011 REVISED Adult Guidelines I gave a link before to this reference, but it was not to a free pdf, but I had the pdf on my desk top, but could not remember where I got it from. I found it, so here is the link to the full article - all 74 pages. This one article answers so many questions that have been presented here. Please everyone, give it a read. Thank you! :) ~ty ( talk) 13:30, 15 August 2012 (UTC)
What happened to waiting for the peer review comments before moving forward? Are we back to debating this, or are we waiting. Please cite references, not your POV. Tanya~ talk page 00:41, 18 August 2012 (UTC) This is a zoo! No more editing needs to be done without our peer reviewer here. Tanya~ talk page 05:00, 18 August 2012 (UTC)
These are not POV's: The reference is the DSM and even the page numbers are given. The DSM-III, originally published in 1980, formally specified diagnostic criteria for MPD, and every other recognized mental illness. The DSM-III-R (1987) states on p. 271: "Onset of Multiple Personality Disorder is almost invariably in childhood, but most cases do not come to clinical attention until much later." On the same page it also states: "Recent reports suggest that this disorder is not nearly so rare as it has commonly been thought to be." Not until the DSM-IV, in 1994, was there overt recognition in the DSM that DID could be diagnosed in children. Children are addressed in a single sentence (p. 484). Explicit attention is not given to DID in children until the DSM-5, and the exact form it will take is still to be determined. Tanya~ talk page 01:29, 18 August 2012 (UTC)
You mentioned Ross above. It's only tangentially related to the topic, which is why I started my comment with "incidentally".
How am I cherry-picking? I'm relying on peer-reviewed, secondary sources - review articles published in good journals - published by psychiatrists, psychologists and related experts. I'll admit I spend more time on the iatrogenic hypothesis, but then again you constantly challenge that model. I look up sources to address your criticisms, I find them fairly easily, and I add them to the page. Because I have limited time I don't end up spending as much time reading up on the traumagenic side. That aspect of the page should be expanded as well, I just don't happen to be doing it. My preferred way to address claims that my edits are undue weight is to find as many sources as I can that demonstrate my edits are supported by reliable, scholarly sources. It's a pretty good way of doing things, one that directly addresses NPOV's statement that weight is demonstrated through sources, not editor assertion.
The accusation of cherry-picking is an unpleasant one given the amount and quality of sources I use. Please note that I am not happy that I have to defend my edits yet again, despite the number and quality of sources that support them. WLU (t) (c) Wikipedia's rules: simple/ complex 03:03, 18 August 2012 (UTC)
So WP is not about mainstream consensus of the experts on DID it is about you taking the side of the minority POV of DID against me. There is something really wrong here. The WP page is not what you or I want. It's suppose to reflect the mainstream consensus of the experts in DID. pdf file (p.122-124) Tanya~ talk page 04:56, 18 August 2012 (UTC)
Tylas, interstitching comments like you do here really makes it difficult to follow the discussion. Responding to your substantive point, it is predicated on the assertion that your opinions represent the mainstream consensus of experts on DID. I do not believe you have backed up this assertion, and in fact the number and publication views of those who explicitly disbelieve the traumagenic hypothesis suggests, as I have said before, that either the traumagenic hypothesis is not the mainstream view, or that there is a substantial minority of scholars publishing their doubts in peer reviewed journals - and therefore discussion of their points on this page is perfectly legitimate. WLU (t) (c) Wikipedia's rules: simple/ complex 05:04, 18 August 2012 (UTC)
Reply to my "substantive point" - I am working on it in this sandbox since we have done this numerous times, I would like it one place so I don't have to keep redoing the work. This will take a while. There is about 72 pages or so just in the one 2011 Review article pdf file I address there, so be patient. When our peer review has time to catch up this his other concerns then we can address this. We should not be overwhelming him when he has made it clear he is busy and traveling. Thank you team. Of course when our peer reviewer is ready, then we can move the points here that need to be discussed further. Acceptable? Tanya~ talk page 18:04, 18 August 2012 (UTC)
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The new version of the lead simply reintroduces all the old problems. Most of the current focus of the current lead is on relatively unimportant details that people can go to the body of the article to find out for specifics. Almost f the entirety of the changes were to minimize all mention of the controversy and hide it behind jargon that most people here will not understand.
While all DSM diagnoses are controversial, it is a bit disingenuous to claim that the controversy on this one doesn't need much space in the lead because of rampant controversy. The *kinds* of controversy and level of controversy between this diagnosis and others are quite a bit different. Very few people dispute schizophrenia exists at all or think that people who report symptoms are doing so because their therapist talked them into it.
From comments above I am not surprised that Mathew is whitewashing the article, but I am very disappointed in DocJames. To pretend that this isn't a more controversial diagnosis than most while at the same time provided a quot from a reliable source on the talk page to the contrary is really bizarre.
Unless these concerns are addressed I will revert back to the previous version. WP:NPOV policy is very clear on this. DreamGuy ( talk) 22:24, 29 July 2012 (UTC)
With respect to Wikipedia policy DreamGuy has support to revert to the previous version. One is not to start an edit war following this but to start a WP:RfC. Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 23:20, 29 July 2012 (UTC)
Question for Doc - What do we need to work on to make the current version something that is not bait for reversion? Give me a task and I am on it! ~ty ( talk) 00:46, 30 July 2012 (UTC)
Can we agree that this is a misleading statement that is currently in the lead? "Consensus is NOT lacking in the diagnosis and treatment of DID." I would think that the DSM-IV gives a consensus for a Dx of DID and the 2011 revised treatment guidelines ISSTD gives the guidelines for the treatment of DID. If this is not enough here is a [ http://psycnet.apa.org/psycinfo/2011-28153-001/ current review article by some major brains in the area of trauma and DID: Brand, Bethany L.; Myrick, Amie C.; Loewenstein, Richard J.; Classen, Catherine C.; Lanius, Ruth; McNary, Scot W.; Pain, Clare; Putnam, Frank W. . This review appears to agree with the 3 phase method already widely in use and suggested by the ISSTD. ~ty ( talk) 21:12, 29 July 2012 (UTC)
re controversy. I agree. I think all too much emphasis is placed on the controversy in the article (when controversy is endemic in psychology/psychiatry) and not enough on our lack of knowledge and the true confusion that surrounds this diagnosis and personality functioning in general. It's a much more interesting topic when explored as knowledge seekers than in taking sides over a controversy. MathewTownsend ( talk) 21:52, 29 July 2012 (UTC)
I am only addressing (for right now) the parts that were left in the lede before Dreamguys revert. Afterwards there is a host of errors to address!
Problem in the lede: http://www.ncbi.nlm.nih.gov/pubmed/18569730 It is ref #8 on the DID article This is a poor abstract that lays out a problem, then says what "the paper" will address. But no results or conclusions are reported.Research on treatment effectiveness always focuses on "clinical approaches", and at the beginning of a body of research the focus is always on case studies: "I took a client and did treatment X and here's what happened. Now we need a clinical study of a sample, etc." ~ty ( talk) 00:07, 30 July 2012 (UTC)
Another problem with the lede: "No systematic, empirically-supported approach exists." Kluft's report of over 200 of his cases yields a sustained full remission at 5 years after termination of treatment of ~85%. ~ty ( talk) 00:18, 30 July 2012 (UTC)
And another problem in the lede: "DID does not resolve spontaneously, and symptoms vary over time." What is the point of this sentence? Why is it in this paragraph? ~ty ( talk) 00:20, 30 July 2012 (UTC)
Another problem in the lede: "In general, the prognosis is poor, especially for those with co-morbid disorders." It is poor unless one gives appropriate treatment, a summary of which is detailed in Howell book.. Howell treatment model contains improvements: specific, proven therapy for trauma (something which Kluft says he always found necessary) - EMDR. So we might now reasonably assume that a treatment success rate of 85% is a lower limit of what good treatment would achieve. This makes treatment of DID more successful than the great majority of mental health disorders.
I am working on prognosis right now, but if anyone is doing cause, I found a good 2008 pubmed review article on DID. J Trauma Dissociation. 2008;9(2):249-67. Familial and social support as protective factors against the development of dissociative identity disorder. Korol S. ~ty ( talk) 03:12, 30 July 2012 (UTC)
I am working on this section here. I am reading a bunch on this, since of all the aspects of DID to study, this is the one that I have not looked into in depth, so this is interesting. Help is always greatly appreciated! ~ty ( talk) 13:27, 30 July 2012 (UTC)
This is what I have. Anyone have suggestions or changes for this? First is the text for the DID page, followed by support for the last sentence.
Generally, the earlier one is diagnosed the better the prognosis and even greater if diagnosis and treatment is obtained during childhood. Prognosis becomes far less optimistic if not appropriately treated. Successful treatment (psychotherapy) for adults usually takes years depending on ones goals; to operate as a unified self and free of the effects of DID or become coconscious, still having DID. If the typical 3 phase treatment for DID is completed, dissociative boundaries are reduced resulting in a unified self and elimination of the effects and symptoms of trauma memories. Therapy is not easy and hospitalization can be required for some patients. This chronic disorder rarely resolves spontaneously if ever. [2][3] [2] Individuals with primarily dissociative symptoms and features of post traumatic stress disorder normally recover with treatment. Many patients have a history of being sexually abused as a child and often cope by abusing alcohol or other substances - a negative way of coping with their victimization. Those with co-morbid addictions, personality, mood, or eating disorders face a longer, slower, and more complicated recovery process. Individuals still attached to abusers face the poorest prognosis; treatment may be long-term - and consist solely of symptom relief rather than integration. Changes in identity, loss of memory, and awaking in unexplained locations and situations often leads to chaotic personal lives. [3] Individuals with the condition commonly have histories of failed suicide attempts and self-harm. [4][5][6] ~ty ( talk) 16:22, 30 July 2012 (UTC)
It we could be more specific when it comes to referencing by adding the exact quote from the reference in question that would make things easier. Typically our paraphrasing should not be much different than the original. Here is a an example.
Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 21:08, 30 July 2012 (UTC)
DID treatment is supported by a body of prospective data in a well-defined population using valid and reliable measures of psychopathology.
Support for this statement
Summary of Ross and Halpern (2009): Ideally, treatment outcome studies are "...randomized, prospective, double-blind placebo-controlled.." designs. "Prospective" means we start with a condition, apply treatment, then see what happens. Most DID studies are retrospective - we're done with treatment, and we look back. This is important because retrospective studies do not have dropouts, a significant issue in proper studies.
Where DID is concerned, there are multiple essentially insurmountable hurdles here:
What this means is that there likely will not be a really good treatment outcome study for DID any time soon, if indeed ever. The hurdles are really big. Therefore, in the meantime acceptance of other studies if the norm.
Next, we look at treatment outcome studies in mental health. Here, they look only at medication. There is no mention of psychotherapy models other than theirs. This is a major flaw of their analysis, for a reason that may not be obvious. Basically, psychotherapy typically gets better results than do drugs. For many technical reasons Ross and Halpern (2009) summarize psychotropic medication, in general, as not especially effective. Reported successes are almost surely inflated due to inherent research design errors.
Moving to DID, Ross and Halpern (2009) comment that these "patients" are so complicated that they would simply be excluded from normal treatment studies, because: most have been psychiatric inpatients or have been suicidal, and most have other Axis I disorders including addictions. Such subjects just are not used in treatment studies - too many factors are in play to do a good study.
They then present treatment outcome data for participants in their treatment program in Texas.
My conclusion from the Ross and Halpern (2009) book: "The treatment techniques described in this manual are supported by a body of prospective data in a well-defined population using valid and reliable measures of psychopathology."
Never mind ~ty ( talk) 22:42, 30 July 2012 (UTC)
Traditionally dissociative disorders such as DID were attributed to trauma and other forms of stress that caused memory to separate or dissociate, among other symptoms, but research on this hypothesis has been characterized by poor methodology. So far, experimental studies, usually focusing on memory, have been few and the research has been inconclusive. [1] It became a popular diagnosis in the 1970s but it is unclear if the actual incidence of the disorder increased or only its popularity. An alternative hypotheses for its etiology is that DID is a product of techniques employed by some therapists.
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The section on epidemiology is full of primary research papers. Are there not secondary sources that give ranges for different populations? Once this section and the controversy surround prevalence has been improved here than a smaller summary can be added to the lead. My comments above on gender ratios belong here not in the lead. Belong in both spots maybe...
Doc James (
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Doc, I agree that we need to do the body first and the lead should be based upon the body. Unfortunately that's not what recent edits were doing. The gender disparity, for example, is interesting and definitely deserves a place in the body, but it got added the the lead right away and then tacked on to the body as an afterthought. Out of all the wide things that can be in the lead, something that was just tossed together and up to this point anyway showed no overall notability seems like an odd choice. And I say that as someone who put that back into the lead when reverting to the old consensus version because nobody objected to it. (As mentioned above, I think experts talking about why they think the gender disparity is there -- or if there are any studies on that specific topic somehow -- would be very valuable to the article, as compared to tossing it out there as a factoid.)
Recent discussions on the controversy suggested it shouldn't be there because there was no controversy section, which is missing the point entirely. The things mentioned in the lead that some people tried to remove (or reword so that it was incomprehensible to an average reader) are fully detailed in the body of the article in various places. They were being removed despite the fact that they accurately summarized the article. And we have discussion on this very talk page that explained all of that already, multiple times. It is incomprehensible how someone who was advocating editing the lead last was busy chopping it to pieces and adding wholly new material never before present in the article. DreamGuy ( talk) 02:34, 31 July 2012 (UTC)
I recommend working this up to GA status as this is then a consensus version that folks can refer back to when problems arise in the future. FA would be better but probably a tad ambitious..... Casliber ( talk · contribs) 00:51, 30 July 2012 (UTC)
While we do not typically have sections on controversy. Maybe in this article like for ADHD we should? We could put this text there?
DID is a controversial diagnosis. Supporters attribute the symptoms to the experience of pathological levels of stress, which they say disrupt normal functioning and force some memories, thoughts and aspects of personality from consciousness (dissociation); [1] [2] an alternative explanation is that belief in these dissociated identities is artificially caused by certain [[psychotherapy| psychotherapeutic]] practices and increased focus from the [[mass media| mass media]], leading the patients to imagine symptoms that did not exist prior to therapy. [3] [4] [5] [6] [7] [8] The debate between the two positions is characterized by intense disagreement. [3] [5] [6] [8] [9] [10]
Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 01:36, 30 July 2012 (UTC)
This is not what I meant. Thus I have moved the content that was moved in these edits [2] and [3]. Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 20:47, 30 July 2012 (UTC)
Please see Wikipedia:Criticism#Avoid_sections_and_articles_focusing_on_.22criticisms.22_or_.22controversies.22. DreamGuy ( talk) 01:51, 31 July 2012 (UTC)
Tylas reverted my edit with the summary "because we are working on it. Please be patient rather than reverting. Work with us - not against us please!" Tylas, I am part of that "we". The controversy is a very notable part of DID, probably far better known to most clinicians than the specifics of treatment. The body still contains considerable discussion of the controversy, and the lead should summarize the body. The version before my edits contained only two sentences on the controversy, with no indication of why DID is controversial, only that it is. The reasons can be summarized briefly, and in my opinion should be included. I'm not sure why you think my opinion should be casually discarded when it is quite in keeping with WP:LEAD. WLU (t) (c) Wikipedia's rules: simple/ complex 20:02, 30 July 2012 (UTC)
sorry, WLU, not sure what you are saying. There is a misunderstanding. Nothing in the article has been removed/added/changed because of the peer review. I started it to seek feedback from the people who do peer reviews. As you can see from the peer review page Wikipedia:Peer review/Dissociative identity disorder/archive1, there's been no responses. And I really don't expect any, given the topic. MathewTownsend ( talk) 21:12, 30 July 2012 (UTC)
I am unsure why this well supported content was removed? [4] and [5] One set of text was supported by major textbooks and the other by a 2011 review article (PMID:2182904) Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 20:51, 30 July 2012 (UTC)
If we simple use recent secondary sources and give similar weight that they give we should be good. Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 23:53, 30 July 2012 (UTC)
What somehow appeared in the lede today: It became a popular diagnosis in the 1970s but it is unclear if the actual incidence of the disorder increased or only its popularity. An alternative hypotheses for its etiology is that DID is a product of techniques employed by some therapists and disagreements between the two positions is characterized by bitter debate.[11][12][13][14][3][15] Critics of the diagnosis point to characteristics such as the rareness of the diagnosis before 1980, the lack of children with DID, vagueness of the diagnostic criteria and terminology, changes in the number and forms of patient alters and the clustering of the diagnosis around certain clinical groups as evidence that the condition is due to social role-play rather than a true mental illness.[15][16]
This is a mess, a long paragraph with [11][12][13][14][3][15] all this to try and give credit to one sentence. The problem is that probably most of this stuff was taken out of context. If you are going to say there is "bitter debate" then you need to say about what exactly, not just give a long list of papers that might have similar words, that actually mean totally different than what you are implying. The Text book Doc James posted answers all these claims (I think all quite actually), but to go back and forth on all this would make the article long and boorish and still never tell people what DID is. This is just old boring stuff. What is interesting is what is real and now understood.
Critics of the diagnosis point to characteristics such as the rareness of the diagnosis before 1980, the lack of children with DID, vagueness of the diagnostic criteria and terminology, changes in the number and forms of patient alters and the clustering of the diagnosis around certain clinical groups as evidence that the condition is due to social role-play rather than a true mental illness.[15][16] This is just more of the same ~ty ( talk) 23:41, 30 July 2012 (UTC)
While adding footnotes is helpful, adding too many can cause citation clutter, which can make articles look untidy in read mode, and unreadable in edit mode. If a page has extra citations that are either mirror pages or just parrot the other sources, they contribute nothing to its reliability while acting as a detriment to its readability. One cause of "citation overkill" is edit warring, which can lead to examples such as "Garphism is the study[1][2][3][4][5] of ...". Extreme cases have seen fifteen or more footnotes after a single word, as an editor desperately tries to shore up his point and/or overall notability of the subject with extra citations, in the hope that his opponents will accept that there are reliable sources for his edit.
One cause of "citation overkill" is edit warring, which can lead to examples such as "Garphism is the study[1][2][3][4][5] of ...".
Someone has updated the recommendations on citations in the lead to mach with reality :-) [6] Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 03:27, 31 July 2012 (UTC)
I noticed in the signs and symptoms section this was written: "Despite research on DID including structural and functional magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, event-related potential and electroencephalography, no convergent neuroimaging findings have been identified regarding DID..."
But then the last sentence of the same paragraph states, "DID patients may also demonstrate altered neuroanatomy."
This seems confusing and contradictory to me.
(Sorry if I'm just misunderstanding or going about things the wrong way; I'm new here.) Dirajero ( talk) 00:24, 31 July 2012 (UTC)
Everyone is talking every which way and making large numbers of edits to the article, and very few of these changes are being discussed. Even fewer are receiving anything like a wide agreement.
On controversial topics, the goal of NPOV policy is not that everyone is happy, but that everyone (or as many people as possible) agree that the wording that exists is fair and accurate. Many of the recent edits have been in areas that anyone looking at this topic page would know were already discussed as unfairly slanted and inaccurate. We all know this is a very controversial article. Nobody can in good conscience ignore that. To ignore that and rush ahead suggests you are not interested in working with others. It shows bad faith in your edits here. I know people are emotional, but everyone needs to follow our policies. I can understand why newbies might make this mistake, but for editors who have been around a long time it's incomprehensible.
Per WP:BRD, I have reverted to the last stable version. DocJames above said I had every right to do so in this situation, so I did. This version is the version closest to the one that had consensus for many months here, other than a few changes made to fit what everyone I've seen so far agreed on (removing mention of Sybil, though I did so reluctantly until we have better wording we can agree upon) DreamGuy ( talk) 02:17, 31 July 2012 (UTC)
Your latest addition ("Disturbed and altered sleep has also been suggested as having a role in dissociative disorders in general and DID in specific. [11]" is very interesting. Now that I've been looking at the recent literature, I see that the research has turned toward examining the memory functioning from a neurological view, examining avenues like altered sleep etc. Since psychiatry in general is leaning more toward genetic and neurobiological influences, it makes sense that if the field would drop this dichotomy of real versus play acting and start actually examining what is going on, it could get really interesting! Thanks! MathewTownsend ( talk) 02:36, 31 July 2012 (UTC)
This is a great new section. I am going to do some more reading on this. Thanks to whoever added it! ~ty ( talk) 00:22, 1 August 2012 (UTC)
Wikipedia has no deadline per WP:NODEADLINE. No one person should write this article and no one should be making big changes in one day. This article is a collaboration. Many of your problems come from doing too much too fast. Slow down! This article is about a diagnosis, not about anyone's personal experience. MathewTownsend ( talk) 01:11, 1 August 2012 (UTC)
Under "Signs and symptoms" where it says: "The majority of patients with DID report a history of abuse, both sexual and physical during their childhood." I edited out the phrase "resulting in feelings of shame and fear that might inhibit reporting symptoms." This is no different from any individuals who have a "history of abuse, both sexual and physical during their childhood", so this is not characteristic of those diagnosed with DID. I hesitated about the inclusion of "Individuals with DID may experience distress from the consequences of DID rather than from the symptoms themselves." It is cited to an article recommending future directions for DSM-V - but since I don't have access to the whole article, I don't know what empirical evidence Spiegel is basing this on. MathewTownsend ( talk) 23:43, 1 August 2012 (UTC)
Hales-prognosis - quote=Furthermore, because most patients with DID report histories of sexual and physical abuse, the shame associated with that experience, as well as fear of retribution, may inhibit reporting of symptoms.
See page 683 - under the title "Course" on the right side of the page - it is a little less than halfway down that column. Also I have no idea why it has a citation of Spiegel. I did not do that. ~ty ( talk) 00:09, 2 August 2012 (UTC)
If you don't know how to add a quote to a citation template, ask. I don't see the need for a large number of quotes anyway, the points that are having quotes added to them are not being challenged that I can see, nor are they so fine or nuanced that they need a direct quotation to avoid misrepresentation. Quotes add to the length of the page (and the page is already quite long), and for the most part do not add to the interpretation. If the text says "DID rarely if ever goes away without treatment", I do not see a need for a quote saying "but dissociative identity disorder does not resolve spontaneously". WLU (t) (c) Wikipedia's rules: simple/ complex 21:54, 31 July 2012 (UTC)
Patients are often hesitant to complete psychotherapy due to fear and shame from the abuse suffered in their childhood
Furthermore, because most patients with DID report histories of sexual and physical abuse, the shame associated with that experience, as well as fear of retribution, may inhibit reporting of symptoms
Resolution of symptoms of DID is important to more than just the DID patient but to the well-being of off-spring as well. Parenting is quite difficult for the person with DID, even though it might not be obvious to them, severe dissociation and other actions affects their children
One last consequence of DID is the subject's inability to be adequate parents, at least while symptomatic
I agree with WLU. Quotes are not needed, indeed they clutter the text, unless it is an unusual or unlikely statement. Also, it's not good to cite the same source over and over per WP:UNDUE. No one authority needs to be used as a source more than a few times. MathewTownsend ( talk) 00:18, 1 August 2012 (UTC)
Please Tylas, the prognosis section is not solely your responsibility. Best to add a little now and then per day, while keeping the balance of the entire article in mind. Then reflect on the whole and read more sources. IMO, there isn't a whole lot to say about prognosis as there are few reliable secondary sources that address the subject, especially review articles. For example, the statement: "Prognosis can be excellent; case studies report that most cases of DID resolve with proper therapy, but there are no controlled trials." This sentence gives us little useful information as case studies by their nature are not valid for outcome statements. And they are usually written by proponents of the therapy who are going to report favorable outcomes and therefore are not NPOV. No controlled trials means we have no information on prognosis. MathewTownsend ( talk) 13:25, 1 August 2012 (UTC)
A good way to start is to read the article and make little copy editing changes, like spelling etc. Then, since this is a controversial article, why don't you discuss any proposed changes on the talk page first. Then, make a few small changes and see how they are received by other editors. No one should be putting such a large amount of text that if it's deleted they can't handle it. (And remember, anything you write is still in the article history and can be retrieved.) If someone makes a deletion you disagree with, take it to the talk page and discuss it. Remember, other editors, like WLU, have worked long and hard on this page over a period of years so think how they are going to react when you make many major changes to the article without consulting others in a few days. MathewTownsend ( talk) 16:13, 1 August 2012 (UTC)
Using the word "personality" simply continues to confuse people about not only DID, but basic psychology. I refer you back to my section titled Psychology 101 which explains this. I will look for it on the talk page. It might have been archived. 21:42, 2 August 2012 (UTC) ~ty ( talk) 21:46, 2 August 2012 (UTC)
"Despite the lengthy history of the psychopathology of dissociative disorders, and the intense study by Pierre Janet in the first part of the last century and by Jean-Martin Charcot before him, dissociative disorders have been largely disregarded since Freud and have not received serious attention again until recently.[45] Prior versions of DSM have avoided consideration of etiology in an effort to distance itself from Freudian psychology. DSM-V is attempting to reintroduce etiology; and the "development of a pathophysiologically based classification system" has been advocated such as investigation of the neuroevolution of "stress-induced and fear circuitry disorders and related amygdala-driven, species-atypical fear behaviors of clinical severity in adult humans."[46]"
I just read this. Wow! Now that is someone that understands what is going on both with history and the DSM. Thank you to whoever did this. It's a breath of fresh air! I think advocated is spelled wrong. Will fix for you. :) ~ty ( talk) 01:08, 1 August 2012 (UTC)
Because it hasn't happened yet and when it is published it may not reflect the published proposals. It is not part of the diagnosis now, which is what this article is about. And Casliber is a psychiatrist, and he thinks its inappropriate to include it. (And I agree with him.) He wrote Major depressive disorder which you might take a look at as a model for how an article on a psychiatric diagnosis should be formatted. MathewTownsend ( talk) 21:33, 2 August 2012 (UTC)
What (Spiegel D, Loewenstein RJ, Lewis-Fernández R, Sar V, Simeon D, Vermetten E, Cardeña E, Dell PF.) say about DID in this review article is that:
3. The diagnostic criteria for DID should be changed to emphasize the disruptive nature of the dissociation and amnesia for everyday as well as traumatic events. The experience of possession should be included in the definition of identity disruption.
There is a growing body of evidence linking the dissociative disorders to a trauma history, and to specific neural mechanisms. ~ty ( talk) 01:04, 2 August 2012 (UTC)
Here is a great review article on dissociation by David Spiegel MD. In the article it says there is controversy about what dissociation is. This article should help with that. ~ty ( talk) 18:15, 2 August 2012 (UTC)
I was bold and removed the DSM-V section per Casliber above. I believe there are compelling reasons not to include it, aside from the fact that it is not a final version. It only adds more complex terminology to the article without clarifying anything. MathewTownsend ( talk) 19:47, 2 August 2012 (UTC)
Can those who have been editing please archive threads which are resolved or repeated elsewhere. Also, if good sources have been found, can someone note that they've been added. I've just started to read this talk page and am trying to figure out where to start..... Casliber ( talk · contribs) 12:44, 2 August 2012 (UTC)
The next step is to look at Medical article guidelines and Good Article guidelines and see how the article squares up. I agree that Peer Review is generally a good idea, though I worry that it will fork discussion into two places..... Casliber ( talk · contribs) 12:44, 2 August 2012 (UTC)
There is "considerable delay between initial symptoms" and the time DID "emerges." Usually DID does not "emerge" before adolescence. name=Hales-prognosis>"Course". p. 283. {{
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Does anyone argue this change?
~ty (
talk) 00:24, 2 August 2012 (UTC)
I am confused. The WP article says "To date approximately 250 cases of DID in children have been identified, though the data does not offer unequivocal support for either theory.", but the reference I look at (and I want to read the entire article, but there is only an abstract there says: "The review produced a total of 255 cases of childhood DID reported as individual case studies" The WP statement makes it sound like there have only been about 250 cases ever of diagnosed DID. Is this right? I must admit, I have not dug much into childhood DID. ~ty ( talk) 00:39, 2 August 2012 (UTC)
Here is the article: RESULTS:
The review produced a total of 255 cases of childhood DID reported as individual case studies (44) or aggregated into empirical studies (211). Nearly all cases (93%) emerged from samples of children in treatment, and multiple personalities was the presenting problem in 23% of the case studies. Four US research groups accounted for 65% of all 255 cases. Diagnostic methods typically included clinical evaluation based on Diagnostic and Statistical Manual of Mental Disorder criteria, but hypnosis, structured interviews, and multiple raters were rarely used in diagnoses.
CONCLUSION:
Despite continuing research on the related concepts of trauma and dissociation, childhood DID itself appears to be an extremely rare phenomenon that few researchers have studied in depth. Nearly all of the research that does exist on childhood DID is from the 1980s and 1990s and does not resolve the ongoing controversies surrounding the disorder. ~ty ( talk) 01:32, 2 August 2012 (UTC)
O-kay - I can't see the google book pages but have a word of caution to add. One interpretation is that identities are an extreme expression of a normal human phenomenon. Children from the age of two might pretend to be a dog or a cat and get really overinvolved. Young children have quite different reality-testing to adults. Adults don't adopt personas per se but do act differently and pervasively depending on the role they are in, hence a doctor, lawyer, rock musician will have a different selection of behaviours if they are in their job role, with friends, or family etc. Anyway this is getting off topic but I'll try and take a look at the research. Casliber ( talk · contribs) 13:07, 2 August 2012 (UTC)
In this edit the key point that "Prognosis when untreated, is poorly understood" was removed with the inaccurate summary of "add back another part" [8]. This has now occurred a number of times and I have replaced it again. Doc James ( talk · contribs · email) (if I write on your talk page please reply on mine) 17:38, 2 August 2012 (UTC)
If a reference mentions a certain point, but the point of the reference is to disagree with what that point, should it be used as a reference to support the subject it is arguing against? One example below?
Therapist induced - header
Please don't cut and paste citations as you did above. Put clickable sources in your statement. The cut-and-paste numbers will change if someone adds another citation. And it makes it hard to figure out what you're saying since I have to go back and forth from your cut-and-paste to the article. MathewTownsend ( talk) 15:38, 4 August 2012 (UTC)
Interesting points Mathew. WLU, I was not looking to replace the iatrogenic stuff, I was just wondering if that was a good source to use, but since you bring it up, there are lots of references out there that could be used to show that iatrogenic and trauma/DA are not equal. Doing a quick search of reviews, here is the first one I found:
* Abstract "The incidence of dissociative identity disorder (DID) is strongly correlated with exposure to serious physical and sexual abuse. Although studies of more than 1,000 DID sufferers indicate that severe child abuse is a predisposing factor in 95% to 98% of cases (B. Braun, 1988), abuse alone is not, in fact, predictive of DID (B. Rind & P. Tromovitch, 1997). Disorganized/disoriented attachment style and the absence of social and familial support, in combination with abuse history, best predict DID (D. Howe, 2006; R. Kluft, 1984; K. Lyons-Ruth, L. Dutra, M. Schuder, & I. Bianchi, 2006)."
I am going to add this information to the trauma section, when I have a moment. Any objections before I do? It is a review article and it is newer. ~ty ( talk) 04:58, 5 August 2012 (UTC)
As far as I can tell I've consolidated all the references so there is no more duplication of sources. WLU (t) (c) Wikipedia's rules: simple/ complex 02:40, 5 August 2012 (UTC)
If it is, it counters some of the claims in the WP article. Here are a couple of examples:
Look at the references they list for the Medline article. Only a few deal with DID. Most refer generally to "dissociation" if they mention it at all. Many are on child abuse without mentioning dissociation. Many are on PTSD. Most are primary research. Many were done in the 1980s and 1990s. The article seems to confuse DID, dissociation, PTSD. There is a huge concentration on studies of child abuse but they don't have solid review articles linking it to DID. Many other problems with the references.
Look for yourself:
MathewTownsend ( talk) 02:03, 5 August 2012 (UTC)
Article authors: Contributor Information and Disclosures Author
Muhammad Waseem, MD Associate Professor of Emergency Medicine in Clinical Pediatrics, Weill Medical College of Cornell University; Consulting Staff, Department of Pediatrics, Bronx Lebanon Hospital; Consulting Staff, Department of Emergency Medicine, Lincoln Medical and Mental Health Center
Muhammad Waseem, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Heart Association, and American Medical Association
Disclosure: Nothing to disclose. Coauthor(s)
Muhammad Aslam, MD Instructor in Pediatrics, Harvard Medical School; Staff Physician, Department of Medicine, Division of Newborn Medicine, Children's Hospital Boston
Muhammad Aslam, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Medical Association, Massachusetts Medical Society, and Southern Medical Association
Disclosure: Nothing to disclose.
Richard M Switzer, Jr, MD Consulting Staff, Department of Pediatrics, Brooklyn Hospital Center
Richard M Switzer, Jr, MD is a member of the following medical societies: American Academy of Pediatrics and American Medical Association
Disclosure: Nothing to disclose.
Orlando Perales, MD Associate Director of Pediatric Emergency Services, Department of Emergency Medicine, Lincoln Medical and Mental Health Center
Orlando Perales, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose. Specialty Editor Board
Carol Diane Berkowitz, MD Executive Vice Chair, Department of Pediatrics, Professor, Harbor-University of California at Los Angeles Medical Center
Carol Diane Berkowitz, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, American College of Emergency Physicians, American Medical Association, American Pediatric Society, and North American Society for Pediatric and Adolescent Gynecology
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Caroly Pataki, MD Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.
Carrie Sylvester, MD, MPH Senior Child and Adolescent Psychiatrist, Sound Mental Health
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry
Disclosure: Nothing to disclose. Chief Editor
Caroly Pataki, MD Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.
~ty (
talk) 19:45, 6 August 2012 (UTC)
No. Because the articles are out of date, and almost none of those articles indicate that the author is familiar with DID. (Remember "dissociation" or "dissociative disorders" are not the same as DID.) Besides, lots of disorders have a high past history reported of child abuse. (Schizophrenia and Borderline personality, for example. And the field has changed a lot since the 1980s and 1990s) Please read WP:MEDRS. MathewTownsend ( talk) 20:09, 6 August 2012 (UTC)
I removed the following text from the prognosis section:
Changes in identity, loss of memory, and loss of time often lead to chaotic personal lives, since it is common for highly dissociated "personality states" to not know what other "personality states" know due to the amnestic barrier between those "personality states". Psychotherapy for adults usually takes years depending on the patients goal. Unifying or "integrating" the various "dissociated states" of the "personality" is considered best for the patient allowing them to finally operate as a unified "personality" and to have freedom of the crippling effects of DID. Some patients however, for personal reasons, cannot bring themselves to do this, instead they opt to obtain an acceptable level of coconscious, still retaining their dissociated "personality states", but with reduced amnesic barriers.
Prognosis is about the clinical course of a patient. Most of these are symptoms, which is why I moved them to the symptoms section. What isn't a symptom is mostly material for the treatment section, though I've retained the bit about duration and goals of treatment.
Also, Tylas, you do not understand how a ref name tag works. The whole point of a ref name tag is to have a single citation that can be used multiple times. That means there is only one ref name tag with a citation attached, not a series of ref name tags each with a quote attached. If you really feel the need to append a quote next to a citation, I suggest using invisible text, but as I've said before - the quotes are only useful if someone is contesting the material and you're better off just discussing that particular summary and quote than appending it to the text (particularly in a form that doesn't actually display in the footnotes). WLU (t) (c) Wikipedia's rules: simple/ complex 01:52, 5 August 2012 (UTC)
I can't find the section even in the archives, but this is the idea of why using the term personality is confusing to most. Again, I agree with Matthew that personality states is a good idea.
F. Putnuam reported back in 1977 that no "personality state" is an "original part." There is no original part. A persons sense of self is "built up and synthesized over time. E. Howell (2011) adds to this that "the usually presenting part is, by definition, a part in relation to and in relationship with other parts in the total organization of the personality. Current research in neurobiology, cognitive psychology, and developmental psychology indicates that the brain, the mind, and the self are normally multiple. The brain is organized into "neural system" - these systems "function independently. So, no one is born with one unified self (personality). During infancy, behavior is organized as a set of discrete behavioral states (such as deep sleep, awakening, eating) which link and group together in sequences over time. For the natural process of integration to proceed correctly, a child must attach to at least one of their primary caregivers. All people have multiple states or parts of the personality - these parts are called ego states. In the healthy mind, a person can switch from ego state to ego state, which is a smooth process that goes without much notice. Once you understand how the normal process works, then understanding DID is much easier. With the information above in mind, now consider how forming a unitary self can deviate from the norm and cause a major dissociative disorder such as DID. Natural integration which normally occurs during childhood does not take place for whatever reasons. The cohesive self (with it's many ego states) is not formed. Instead of ego states dissociated states (parts) or alters are created.
So, to avoid confusion by readers, I request that we use the term "personality states" rather than "personality." ~ty ( talk) 22:06, 2 August 2012 (UTC)
To WLU - As you have provided many an example that either someone answers you with a satisfactory answer or you do as you want in the article, I demand an answer here or will assume you cannot find one and in that case for this article we need to assume that this controversy you want to push so much is not equal to the mainstream consensus of trauma and DA. You have avoided the direct question so far, yet have continued to delete every single edit I have made. Please answer with direct references to support your POV. ~ty ( talk) 15:33, 5 August 2012 (UTC)
"The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self)." I think this is as close as we can come to a definition of "personality states".
MathewTownsend ( talk) 17:43, 3 August 2012 (UTC)
I agree, we should inform people that there's debate over the terminology, including personality versus personality state.
Also, the mainstream consensus is not "DID is trauma based". That is the consensus at the J Trauma Dissociation, but it's not universal. Merck is one source, an overview source, but it is not the only source. There is genuine, significant debate about DID in the literature, and the page should reflect this. WLU (t) (c) Wikipedia's rules: simple/ complex 13:46, 4 August 2012 (UTC)
The Iatrogenic position is not a significant controversy to warrant more than one controversy section on the WP DID page - which I do strongly feel should be presented. I am bringing this important question to the forefront of discussion, since it is the point of controversy on this page (but not in the real world) and the question keeps getting shoved aside. I asked WLU a direct question which he has not yet answered - other than to give his own POV. I will ask it again below.
I have asked WLU for current references that say that the iatrogenic position is a mainstream consensus of DID, but I only get his personal opinion on it. As WLU often does, I must demand his next work on this page should be to supply such references.
On the otherhand, it is cited over and over again, in text books, on medical sites and in research that THE mainstream consensus is that childhood trauma (and DA) is the cause of DID. ~ty ( talk) 14:53, 6 August 2012 (UTC)
To Tylas
Please listen to Doc James! The causes of all psychiatric disorders is unknown. All proposed "theories" are tentative. The "schizophrenogenic mother" used to be blamed for schizophrenia; now we think it's primarily an inherited predisposition. What someone (even an expert) thought in 1984 about child abuse and "multiple personality" is not necessarily what we think today. Knowledge is not "fixed". That's why we must concentrate on recent research and recent thinking. Consider that we can't define "dissociation" today, or even "personality"! The field is rapidly changing -- very rapidly.
When so many children get abused, why do only some become DID? There are too many unanswered questions to push a particular "cause" of DID. Please lets explore the possibilities as set forth in the literature, and not push one point of view or another. I think more research on the workings of "memory" and examination of "normal dissociation" which we all engage in every day is needed. After all, the concept "personality" is only a model. Maybe we all are "multiple personalities" in one way or another. We all recognize that "memory" can often be false. (Mine certainly can be.) — Preceding unsigned comment added by MathewTownsend ( talk • contribs) 19:15, 7 August 2012 (UTC)
Reply to Mathew: Also please note that I do agree that the 1980's psychology was a mess! It is 2012 now though. Also we can define dissociation! Saying that DID is caused from watching TV and reading a book is nuts. The false memory battle has nothing to do with DID and should not even be dragged into the conversation. Yes, we all have multiple parts to our one personality. DID has little to do with repressed memories of child sexual abuse - in DID dissociated states hold the memories, but trying to remember the abuse is not a goal of therapy in DID! Breaking down the dissociative barriers is! What you wrote is not what DID is about! Those with DID have horrendous symptoms that they need to deal with and it has been shown that proper therapy can correct the problem. Not to discount those that suffered sexual abuse as a child, but this is not the same as DID - those children achieve NORMAL childhood integration and probably do not have disorganized attachment problems! This is not the same as DID or even DDNOS or Complex PTSD. I don't know how to better explain this, but false memory ideas should not be addressed here. This is not a concern having to do with DID at all!
There is valid evidence of therapists creating temporary dissociative personality states and I totally believe this should be included in the DID article. I don't know of any expert in the DID area that does not agree with this. At the same time, this type of therapy is no longer used by any ethical practicing therapist today. ~ty ( talk) 21:49, 7 August 2012 (UTC)
I am glad you asked the questions, but this is not pushing a particular cause of DID! This is what the experts in the field of trauma, the consensus of the EXPERTS think. It is all but a small fringe group that thinks this. Mathew - I thought you were a therapist? You were talking about renewing your CE credits? I am confused. Anyway ---- here is mainstream consensus on how the personality forms, what an ego state is and why only some that are severely abused throughout their entire childhood get DID. ~ty ( talk) 21:17, 7 August 2012 (UTC)
Right now the page uses the 5th edition of Adult Psychopathology and Diagnosis 15 times. I just found out that a 6th edition was printed in 2012, with a completely different set of authors writing the chapter on dissociative disorders (Steven Lynn, Joanna Berg, Scott Lilienfeld, Harald Merckelbach, Timo Giesbrecht, Michelle Accardi and Colleen Cleere, see chapter title page [9]). I'm trying to get my hands on a physical copy of the book because google books preview is of the Kindle edition or something, and is harder to link to specific pages. This is a pretty dramatic switch in authorship, as Cardena was far more in the traumagenic camp, while Lynn et al. are mostly authors in the sociocognitive camp. This is a bit of a weird case, both are reliable sources, both represent very different points of view, and I'm expecting the chapters to be substantially different in emphasis, content and criticality. I'm not actually sure what to do - should all the 5th edition references be replaced, can the 5th edition still be used, can we have "competing chapters" used to cite both sides of an issue? I haven't read the chapter yet so all this is somewhat premature, but I do expect this to have a pretty significant impact on the page so - heads' up! WLU (t) (c) Wikipedia's rules: simple/ complex 19:05, 7 August 2012 (UTC)
DID is a valid psychological diagnosis, a mental disorder that is included in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) and the proposed DSM 5 - a serious mental disorder which is at least as common as Schizophrenia. According to the mainstream consensus in psychology today the trauma model is the best model we have and it explains that the sense of self is "built up and synthesized over time. E. Howell adds to this that "the usually presenting part is, by definition, a part in relation to and in relationship with other parts in the total organization of the personality. Today's research in neurobiology, cognitive psychology, and developmental psychology indicates that the brain, the mind, and the self are normally multiple. The brain is organized into "neural system" - these systems "function independently.
Once you understand how the normal process works, then understanding DID is much easier. With the information above in mind, now consider how forming a unitary self can deviate from the norm and cause a major dissociative disorder such as DID.
1. A baby/toddler does not achieve normal attachment due to severe neglect and severe and constant abuse during the earliest years of life. The same baby/toddler cannot achieve normal integration, again due to severe neglect and abuse. The integration should have happened naturally during the earliest years of life but due to trauma it did not happen.
2. Abuse continues throughout this child's life, a child who never achieved normal integration and is suffers from disorganized attachment. This child can become more fragmented.
Though the vast majority of DID cases are caused by child abuse and neglect (by a child's caretakers) this is not always the case. There are accidental ways a child can experience the early childhood trauma of an abused child - such as hospitilazation, an accident, a death, etc..., but still the cause is trauma.
Check list for DID:
Stress and lack of social support from a primary caregiver is experienced in infancy and continues throughout the early years in those with DID. Children have an innate ability to cope using dissociation and are often able to dissociate memories and experiences from consciousness. These memories and feelings they buried - so to say, are later experienced as a separate entity; if the process is repeated numerous times, multiple parts of the self (dissociated parts) may be created.
Does it make sense now? ~ty ( talk) 21:17, 7 August 2012 (UTC)
Thank you also for continuing to work on our article on DID. However, the study you reference above [11] is a primary source. Please try to follow WP:MEDRS in providing sources, else even the "basics" are not supported. It can't be assumed that the reader knows the "basics" of DID. Also, the definition of DDNOS is incorrect according to the DSM. It isn't a category for those who have have achieved "some normal integration has taken place ..." MathewTownsend ( talk) 13:37, 9 August 2012 (UTC)
Making my argument more clear: Sorry, I did not present this information correctly late last night. I was in a fog of exhaustion. Let me restate: Information from the ISSTD should be used for the WP DID article because many of the authorities in the field are members and in the past information from the ISSTD has not been allow on the WP DID page which is a clear instance of anti-expert bias. My point is that information from the ISSTD should be allowed to be used on the WP DID page. ~ty ( talk) 14:47, 9 August 2012 (UTC)
Please don't go back and edit your comments once others have responded to them, per editing your own comments. It leaves a misleading impression. Readers coming later don't understand all the rewording and deleting you've done, so they won't understand the responses that follow. MathewTownsend ( talk) 18:02, 9 August 2012 (UTC)
I don't see the applicability of the Rind et al. controversy here, as far as I can remember none of the articles touched on DID even tangentially. Correct me if I'm wrong. In any case, though it's part of the overall constellation of memory, abuse and dissociation, the current discussion doesn't make the connection clear. WLU (t) (c) Wikipedia's rules: simple/ complex 13:12, 9 August 2012 (UTC)
“ | Psychotherapists of all people should welcome further evidence of human resilience. But the religious conservatives who hated the message of the Rind et al. study quickly found support from a group of clinicians who still maintain that childhood sexual abuse causes everything from eating disorders to depression to "multiple personality disorder"; and if depressed adults cannot remember having been sexually abused in childhood, that's all the more evidence that they "repressed" the memory. These ideas have been as discredited by research as the belief that homosexuality is a mental illness or a chosen "lifestyle," but their promulgators cannot let them go. These clinicians want to kill the Rind study because they fear that it will be used to support malpractice claims against their fellow therapists.
Indeed, a group of them, whose members read like a "Who's Who" in the multiple personality disorder and recovered-memories business, made this fear explicit in a memo to the CEO of the American Psychological Association: "In addition to the fact that we, as a group, wish to protect the integrity of psychotherapy, we also want to protect good psychotherapists from attack and from financial ruin as a result of suits that are costly both financially and emotionally." To a casual observer, this concern is a non sequitur; what in the world does a meta-analysis on the long-term effects of childhood sexual abuse have to do with the practice of psychotherapy? Good therapy is still helpful for children and adults suffering from traumatic experiences. But bad therapy, such as that based on unvalidated assumptions that sexual experiences in childhood are invariably traumatizing and commonly "repressed," might indeed be in jeopardy from the meta-analysis. Isn't that important news, especially for "good psychotherapists"? |
” |
"there is no actual research that shows that the complex phenomenology of DID can be created, let alone sustained over time, by suggestion, contagion or hypnosis. Reference: International Society for the Study of Trauma and Dissociation (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, third revision. Journal of Trauma & Dissociation. 12:2, p. 124 Please note the HUGE list of respected researchers in the field of DID that have contributed to this 2011 work and that it is your reference #6 at the moment. ~ty ( talk) 13:49, 12 August 2012 (UTC)
This current DID WP page is adding to that confusion presented in the above paragraph. "The difficulties in diagnosing DD result primary from lack of eduction among clinicians about dissociation, DD and the effects of psychological trauma, as well as from clinician bias." Reference: International Society for the Study of Trauma and Dissociation (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, third revision. Journal of Trauma & Dissociation. 12:2, p. 117 Please note the HUGE list of respected researchers in the field of DID that have contributed to this 2011 work. ~ty ( talk) 15:16, 12 August 2012 (UTC)
A Solution to the problem - Why not simply keep this article as the mainstream consensus article and make another that shows the minority POVs? That page can be linked to from this page. WP in an encyclopedia and as such should not be adding to confusion about DID, however for those interested in controversy, there should by all means be a page about it. Per WP guidelines - "The article on the Earth does not directly mention modern support for the Flat Earth concept, the view of a distinct minority; to do so would give undue weight to the Flat Earth belief.
~ty (
talk) 20:10, 13 August 2012 (UTC)
Tylas, have you read WP:NPOV? "Editing from a neutral point of view (NPOV) means representing fairly, proportionately, and as far as possible without bias, all significant views that have been published by reliable sources."
You seem to be suggesting a POV fork, also forbidden by WP:NPOV: "A POV fork is an attempt to evade the neutrality policy by creating a new article about a subject that is already treated in an article, often to avoid or highlight negative or positive viewpoints or facts. POV forks are not permitted in Wikipedia." MathewTownsend ( talk) 20:34, 13 August 2012 (UTC)
The link you give above " Here is the link ( pubmed link) to the new study", is not to a new study but merely to a comment (i.e. opinion) given in response to Boysen's review article. Therefore, it does not meet the requirements of WP:MEDRS. Please read and learn what the requirements are for a reliable source for a medical article and save us all a bunch of trouble. MathewTownsend ( talk) 23:20, 13 August 2012 (UTC)
Reply to Mathew - Sir, I had to back up here. The entire point of this discussion has been lost and we are debating things that were not even questioned. The topic was the question: is the sociocongnitive POV a fringe or minority POV. Where did we even discuss DDNOS and what does this have to do with what we are talking about? I know quite well what DDNOS, particularly DDNOS-1, but where was this even mentioned on this talk page? I offered a great 2012 source written by (Chu, Dell, van der Hart, Cardena, Barach, Somer, Loewenstein, Brand, Golston, Courtois, Bowman, Classen, Dorahy, Sar, Gelinas, Fine, Paulsen, Kluft, Dalenbert, Jacobson-Ley, Nijenhuis, Boon, Chefetz, Middleton, Ross, Howell, Goodwin, Coons, Frankel, Steele, Gold, Gast, Young and Twomby.) and in return have received the 3 articles we are talking about: review on children does not answer the question: is the sociocognitive POV a minority or fringe POV - especially when the author Boysen did not take either side of the argument and the other 2 papers are historic. ~ty ( talk) 00:46, 14 August 2012 (UTC)
The 166th APA Annual Meeting in San Francisco, May 18-22, 2013, will mark the official release of DSM-5. DID in the DSM 5 This is just an update of the update. :) ~ty ( talk) 23:49, 14 August 2012 (UTC)
Full free pdf online: International Society for the Study of Trauma and Dissociation (2011). The full pdf is online for free by going to this page and clicking on the orange link - about the middle of the page: Open a copy of the 2011 REVISED Adult Guidelines I gave a link before to this reference, but it was not to a free pdf, but I had the pdf on my desk top, but could not remember where I got it from. I found it, so here is the link to the full article - all 74 pages. This one article answers so many questions that have been presented here. Please everyone, give it a read. Thank you! :) ~ty ( talk) 13:30, 15 August 2012 (UTC)
What happened to waiting for the peer review comments before moving forward? Are we back to debating this, or are we waiting. Please cite references, not your POV. Tanya~ talk page 00:41, 18 August 2012 (UTC) This is a zoo! No more editing needs to be done without our peer reviewer here. Tanya~ talk page 05:00, 18 August 2012 (UTC)
These are not POV's: The reference is the DSM and even the page numbers are given. The DSM-III, originally published in 1980, formally specified diagnostic criteria for MPD, and every other recognized mental illness. The DSM-III-R (1987) states on p. 271: "Onset of Multiple Personality Disorder is almost invariably in childhood, but most cases do not come to clinical attention until much later." On the same page it also states: "Recent reports suggest that this disorder is not nearly so rare as it has commonly been thought to be." Not until the DSM-IV, in 1994, was there overt recognition in the DSM that DID could be diagnosed in children. Children are addressed in a single sentence (p. 484). Explicit attention is not given to DID in children until the DSM-5, and the exact form it will take is still to be determined. Tanya~ talk page 01:29, 18 August 2012 (UTC)
You mentioned Ross above. It's only tangentially related to the topic, which is why I started my comment with "incidentally".
How am I cherry-picking? I'm relying on peer-reviewed, secondary sources - review articles published in good journals - published by psychiatrists, psychologists and related experts. I'll admit I spend more time on the iatrogenic hypothesis, but then again you constantly challenge that model. I look up sources to address your criticisms, I find them fairly easily, and I add them to the page. Because I have limited time I don't end up spending as much time reading up on the traumagenic side. That aspect of the page should be expanded as well, I just don't happen to be doing it. My preferred way to address claims that my edits are undue weight is to find as many sources as I can that demonstrate my edits are supported by reliable, scholarly sources. It's a pretty good way of doing things, one that directly addresses NPOV's statement that weight is demonstrated through sources, not editor assertion.
The accusation of cherry-picking is an unpleasant one given the amount and quality of sources I use. Please note that I am not happy that I have to defend my edits yet again, despite the number and quality of sources that support them. WLU (t) (c) Wikipedia's rules: simple/ complex 03:03, 18 August 2012 (UTC)
So WP is not about mainstream consensus of the experts on DID it is about you taking the side of the minority POV of DID against me. There is something really wrong here. The WP page is not what you or I want. It's suppose to reflect the mainstream consensus of the experts in DID. pdf file (p.122-124) Tanya~ talk page 04:56, 18 August 2012 (UTC)
Tylas, interstitching comments like you do here really makes it difficult to follow the discussion. Responding to your substantive point, it is predicated on the assertion that your opinions represent the mainstream consensus of experts on DID. I do not believe you have backed up this assertion, and in fact the number and publication views of those who explicitly disbelieve the traumagenic hypothesis suggests, as I have said before, that either the traumagenic hypothesis is not the mainstream view, or that there is a substantial minority of scholars publishing their doubts in peer reviewed journals - and therefore discussion of their points on this page is perfectly legitimate. WLU (t) (c) Wikipedia's rules: simple/ complex 05:04, 18 August 2012 (UTC)
Reply to my "substantive point" - I am working on it in this sandbox since we have done this numerous times, I would like it one place so I don't have to keep redoing the work. This will take a while. There is about 72 pages or so just in the one 2011 Review article pdf file I address there, so be patient. When our peer review has time to catch up this his other concerns then we can address this. We should not be overwhelming him when he has made it clear he is busy and traveling. Thank you team. Of course when our peer reviewer is ready, then we can move the points here that need to be discussed further. Acceptable? Tanya~ talk page 18:04, 18 August 2012 (UTC)
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