Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers

Abstract

BackgroundA diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services.AimTo investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis.MethodStructural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology.ResultsThe pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals.ConclusionsWe propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions.Declaration of interestThe authors declare no competing financial interests.

Sleep, trauma, fantasy and cognition in dissociative identity disorder, post-traumatic stress disorder and healthy controls: a replication and extension study

“…Hence, the current study provides evidence for targeting traumatization as a key predictor of dissociation in individuals with DID. The costs of under-diagnosing DID are high, not only for the individual patients, but also for their residing support system and society as a whole (Reinders et al, 2019). Sleep disturbances are an indicator of mental health suffering (Anderson & Bradley, 2013), but we propose that in DID sleep disturbances are likely to occur as a symptom due to the resurfacing of traumatic childhood experiences, not as causation of DID.…”

“…The current study shows that traumatization is the most important predictor of dissociation in individuals with DID and we assume that sleep disturbances are likely to be related to nightmares due to traumatic childhood experiences. A diagnosis of DID is still controversial (Reinders et al, 2019). When an individual presents with severe dissociative symptoms as well as sleeping problems, we recommend to check for nightmares and investigate the origin of sleep disturbances and to explore a trauma-related disorder, such as DID.…”

“…DID is also under-diagnosed and the most disputed of psychiatric disorders (Reinders et al, 2019). Whether its aetiology is trauma-related, as described in a Trauma Model (TM) (Dalenberg et al, 2012), or related to fantasy proneness, which is referred to as the Fantasy Model (FM) (Dalenberg et al, 2012) (also known as the Sociocognitive model (Spanos, 1994)), is an ongoing debate Dalenberg et al, 2012Dalenberg et al, , 2014Lynn et al, 2014;Merckelbach, Lynn, & Lilienfeld, n.d.;Vissia et al, 2016).…”

What is it about DID? A patient and clinician perspective

“…An increasing evidence base of neurobiological studies supports DID's validity. A study by Reinders et al (2019) found that researchers could discriminate between people with and without DID on the basis of neuroimaging biomarkers with a sensitivity of 72% and specificity of 74%. Blihar et al (2020) completed a systematic review of neuroanatmoical findings in DID demonstrating that people with DID had differences in brain imaging and neural responses compared with controls.…”

Analisis peran perubahan karakter tokoh utama dalam pembangunan tahapan tangga dramatik pada Film SPLIT

“…Ada kalanya ada satu kepribadian primer dan tindakan klinis umumnya dikhususkan bagi kepribadian primer (Delmonte, Lucchetti, Moreira-Almeida, & Farias, 2016;Laddis, Dell, & Korzekwa, 2017;Reinders et al, 2019;Vissia et al, 2016). (Harymawan, 1986).…”