Pre-Thesis Week05 – Dialogic Journal and Article summaries

2018.10.13

These two weeks I’ve been searching for appropriate articles for my topic. I feel like the article research section we did several weeks ago was too rough and at that time I didn’t decide which topic to choose yet. 

I searched NYU Library for my topic Dissociative Identity Disorder and found some very interesting articles. I did a dialogic journal based on these articles I read. 

Dialogic Journal

I printed the articles out and wrote some comments and questions when reading them. Also, I marked some very interesting sections with a red marker. Before reading the articles I sometimes feel confused about what problems and difficulties do people with DID have, and I even do not have a basic understanding of the relationship between dissociative disorder and dissociative identity disorder. With these articles, I obtained a basic understanding and knowledge of dissociative and its branches. These articles also shed a light on the lives of people with DID and discussed how might we help them from both mentally and physically. 

Link of the dialogic journal: https://docs.google.com/spreadsheets/d/1Sl_cYby5kSStNANjNA5S5a-A1dqQBv1ln6gf9J6AA1s/edit?usp=sharing

Article summary

Zeligman, M., Greene, J. H., Hundley, G., Graham, J. M., Spann, S., Bickley, E., & Bloom, Z. (2017). Lived Experiences of Men With Dissociative Identity Disorder. Adultspan Journal, 16(2), 65–79. https://doi.org/10.1002/adsp.12036

Keywords: dissociative identity disorder, mental health, gender
Dissociative

This article reviewed a lived experiences of men with dissociative identity disorder. The authors used a phenomenological approach to uncover experiences of 5 men with dissociative identity disorder. They found out that their experiences could be revealed in 5 themes: history, alters, male gender expectations and identity, challenge, and strengths and support. 

DID has been the most severe and intractable mental disease of the dissociative disorders. Though DID remains underrecognized and underdiagnosed, tests and self-evaluation form of DID has been very popular and reliable. Interviews with 5 men with DID revealed histories of trauma; experience with alters; challenges related to gender; fear of stigma; and acceptance of strength and support from family and community. 

Participants of the test discussed their experience as a man with DID, their difficulties under culture expectation of being a man. The stress of gender expectation has been a barrier to their seeking treatment and sometimes even a trigger for their dissociate. 

They also discussed the current treatment they have received and what they think could be beneficial for people like them; their suggestions of how to make the therapy session more effective.

Costabile, T., Bilo, L., De Rosa, A., Pane, C., & Saccà, F. (2018). Dissociative identity disorder: Restoration of executive functions after switching from alter to host personality. Psychiatry and Clinical Neurosciences, 72(3), 189. https://doi.org/10.1111/pcn.12630

Keywords: dissociative identity disorder, neuropsychologic

This article is a case report, discussed the changes of neuropsychological test results after switching from alter to host personality. Patient in the case experienced a dissociation caused by a near-accident without physical trauma.

The patient dissociated and switched to an alter after the trauma and lost her 15 years of memory. She was able to fixate new memories and act differently from her previous identity in a very short time. From the test results, we could conclude that her new alter is stable and able to take over the whole body. 

The patient recovered her retrograde memory from her first memories until the near-accident. The neuropsychological test result showed her situation is normal. 

Though this case is limited in a single case report, we can apparently conclude that personality switch could affect executive function, and the changes could be measured with available scales.

Kihlstrom, J. F., Glisky, M. L., & Angiulo, M. J. (1994). Dissociative tendencies and dissociative disorders. Special Issue: Personality and psychopathology. Journal of Abnormal Psychology, 103

Keywords: dissociative tendency, dissociative disorder, personality, absorption, psychopathology, hypnosis

This article talked about the history of dissociative disorder and its relationship with personality and psychopathology. Although dissociative disorders are relatively rare, dissociative experiences are rather common in everyday life. Dissociative tendencies appear to be modestly related to other dimensions of personality, such as hypnotizability, absorption, fantasy proneness, and some facets of openness to experience.

These dispositional variables may constitute diatheses, or risk factors, for dissociative psychopathology, but more complex models relating personality to psychopathology may be more appropriate. The dissociative disorders raise fundamental questions about the nature of self and identity and the role of consciousness and autobiographical memory in the continuity of personality.

The article introduced some valuable self-report instrument and some screening device questionnaires for dissociative disorders like the Dissociative Experiences Scale (DES) and M-SCID-D. It also talked about the distribution of dissociative tendencies. From the research results, colleges students score much higher than other ages, which could be an interesting question for my further research.

Webster, K. D., Michalowski, S., & Hranilovich, T. E. (2018). Multimodal Treatment With ECT for Identity Integration in a Patient With Dissociative Identity Disorder, Complex Post-traumatic Stress Disorder, and Major Depressive Disorder: A Rare Case Report. Frontiers in Psychiatry, 9(June), 1–5. https://doi.org/10.3389/fpsyt.2018.00275

Keywords: Electroconvulsive Therapy, identity integration, dissociative identity disorder, post-traumatic stress disorder, major depressive disorder

This article is a case report. The female patient has been suffering from continuously physical and sexual abuse since she was 2 years old. She has been diagnosed with DID, Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD), and chronic suicidality. She has gone through long time therapy but situations went back and force. She was then referred for Electroconvulsive Therapy (ECT), after which the alters began to disappear and finally she now has the alters integrated with her main identity.

The article the history of different kinds of therapies the patient has been taking and multiple medicines she has been taking. But due to the limitation of the only patient who has been recovered from DID, the authors thought this report alone is unable to definitively establish ECT as an effective tool for the integration of personality alters in patients with DID.

Schielke, H., Brand, B., & Marsic, A. (2017). Assessing therapeutic change in patients with severe dissociative disorders: the progress in treatment questionnaire, therapist and patient measures. European Journal of Psychotraumatology, 8(1), 1380471. https://doi.org/10.1080/20008198.2017.1380471

Keywords: Dissociative identity disorder (DID); PTSD; assessment; complex trauma; dissociative disorders (DD); dissociative subtype; outcome; posttraumatic stress disorder (PTSD); progress; questionnaires

This article is a test report of using the Progress in Treatment Questionnaire on people with Dissociative Disorder and their therapist. The result indicates that the PITQ-t and PITQ-p demonstrated good internal consistency and evidence of moderate convergent validity in relation to established measures of multiple character difficulties for DD patients. It demonstrated that the PITQ merit use, additional research, and refinement in relation to the assessment of therapeutic progress with patients with DD.

The article introduced the history of the progress of treatment. It seems like there is only one study for DID-specific progress measure had been developed, and the study was neither assessed validity nor friendly to use in online research, said by the authors. But I would like to dig deeper in for my project to see how far it went on the measurement of DID treatment. 

For the research, the authors measured emotion regulation scale, posttraumatic stress, dissociative experiences scale, and quality of life. It shows that the patient-completed measure demonstrated stronger relationships with established symptom measures than the therapist-completed questionnaire, which indicates the salience of querying patients’ perceptions about their progress in treatment. 

There are still limitations in this research, and for future study, the authors encouraged them to increase representation of groups under-represented in this research, and further examine the PITQ-t and PITQ-p’s consistency and validity in terms of replication and extension. 

Afterthoughts

On week two, we did an article searching exercise and I’ve searched for around 20 journal articles back then. But at that time I wasn’t sure about which topic am I going to choose and what kind of articles am I going to need. But through these weeks’ brainstorming and writing workshops, I sort of figured out the vague topic of my project and now I have some questions I want to figure out by reading articles and case reports.

This time’s article searching has been a lot easier than last time, with much clearer keywords in the search bar. After reading these articles, I have had a basic understanding of dissociative identity disorder and patients with this kind of mental disease. Dissociative Identity Disorder, along with Dissociative Disorder, Post-traumatic Stress Disorder, are very common among people with mental disease, some of them even have multiple different symptoms across multiple diseases. They are suffering from the pain that more than any of us can ever even imagine, while most of ‘normal’ people even don’t know what those mental diseases are, let alone the right way to be an accompany. 

For my thesis project, I want to create something to help them to understand Dissociative Identity Disorder, the lives of people with DID, and the pain they are suffering from. Further away, I’m also thinking about creating a measuring system and/or a calming system for people with DID and their therapist using technology, in order to help to maintain their stability during their therapy and help therapist to track their condition.