The Scientific Status of Childhood Dissociative Identity Disorder: A Review of Published Research

Abstract

Background: Dissociative identity disorder (DID) remains a controversial diagnosis due to conflicting views on its etiology. Some attribute DID to childhood trauma and others attribute it to iatrogenesis. The purpose of this article is to review the published cases of childhood DID in order to evaluate its scientific status, and to answer research questions related to the etiological models. Methods: I searched MEDLINE and PsycINFO records for studies published since 1980 on DID/multiple personality disorder in children. For each study I coded information regarding the origin of samples and diagnostic methods. 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.

Dissociative and Psychotic Experiences of Adolescents Admitted to a Psychiatric Inpatient Unit

“…Middleton and Butler (1998) reported that "patients fulfilling diagnostic criteria for Dissociative Identity Disorder (DID) are regularly seen in Australian inpatient and outpatient settings" (p. 794), but their study was conducted with an adult population and there has not been a more recent update. A very recent review suggested that childhood dissociative identity disorder is rarely seen (Boysen, 2011), supporting the lack of this diagnosis in the current sample of adolescents. It is also acknowledged that clinician bias and lack of clinician education about the nature of dissociative disorders can lead to a lack of appropriate recognition and diagnosis (International Society for the Study of Dissociation, 2005).…”

A Review of Published Research on Adult Dissociative Identity Disorder

“…c) Is DID diagnosed using valid methods? Diagnosis of DID relies heavily on structured interviews, which is consistent with standard practices in psychopathology research and an improvement over the subjective clinical diagnoses that dominate the study of childhood DID (Boysen, 2011). However, the two largest samples, representing a quarter of all new cases, emerged from studies using only clinical diagnosis (Dell, 2006a(Dell, , 2006b.…”

Reply

“…Sar et al [1] have offered points of agreement and criticism concerning my review of childhood dissociative identity disorder (DID) research [2]. To begin with points of agreement, I believe they accept the most important findings from my review.…”