[Dissociative disorders: from Janet to DSM-IV]

Area of Science:

• Psychology
• Psychiatry
• Trauma Studies

Background:

• Dissociation research traces back to Pierre Janet's multifaceted theories on hysteria, incorporating hierarchical, psychological system, and economic models.
• Interest in dissociation and trauma resurged post-WWII, influenced by combatants' symptoms, concentration camp survivors, feminism, media, and recognition of posttraumatic stress disorder (PTSD).
• Dissociative disorders were recognized in DSM-III (1980), with DSM-IV emphasizing the trauma-genic hypothesis and multiple personality disorder (MPD).

Purpose of the Study:

• To review the historical literature on dissociation and dissociative disorders.
• To examine current research trends and assumptions in the field.
• To critically evaluate the trauma-genic hypothesis and the prominence of MPD in current understanding.

Main Methods:

• Literature review spanning historical perspectives from Pierre Janet to current diagnostic manuals (DSM-IV).
• Analysis of research trends and theoretical shifts in understanding dissociation.
• Critical examination of prevailing hypotheses, particularly the trauma-genic hypothesis and the role of MPD.

Main Results:

• Janet's theories provided early frameworks for dissociation, linking it to psychological trauma and specific patient traits.
• Historical events and social movements significantly revived interest in dissociation and trauma.
• Current research, reflected in DSM-IV, often assumes a trauma-genic origin for dissociation and places high importance on MPD, though empirical support and diagnostic clarity are debated.

Conclusions:

• The trauma-genic hypothesis of dissociation requires re-examination.
• The overemphasis on multiple personality disorder (MPD) in current research and classification warrants critical review.
• Further research should consider a broader range of etiological factors beyond early trauma.