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Dissociative disorders.

John F Kihlstrom1

  • 1Department of Psychology, University of California, Berkeley, California 94720-1650, USA. kihlstrm@socrates.berkeley.edu

Annual Review of Clinical Psychology
|August 25, 2007
PubMed
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Dissociative disorders, like dissociative identity disorder (DID), lack strong evidence linking them to trauma due to methodological flaws. Research on amnesia and dissociation needs more rigorous, controlled studies.

Area of Science:

  • Psychiatry
  • Psychology
  • Neuroscience

Background:

  • Dissociative disorders, including dissociative identity disorder (DID), were historically linked to hysteria.
  • A notable increase in DID diagnoses in the 1970s may have been influenced by diagnostic enthusiasm rather than prevalence.
  • Traditional attributions of dissociative disorders to trauma and stress are challenged by methodological limitations in existing evidence.

Purpose of the Study:

  • To critically evaluate the evidence base for the etiology and treatment of dissociative disorders.
  • To examine the methodological quality of studies investigating the link between trauma and dissociative phenomena.
  • To assess the current state of research on dissociative disorders, including amnesia and depersonalization disorder.

Main Methods:

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  • Review of existing literature on dissociative disorders, focusing on etiological hypotheses and treatment outcome studies.
  • Analysis of prospective studies on traumatized individuals to assess the validity of trauma-based amnesia.
  • Examination of experimental studies on memory, particularly state-dependent and implicit memory, in relation to dissociation.

Main Results:

  • Prospective studies of trauma survivors have not yielded convincing evidence for amnesia unrelated to neurological insult.
  • Current treatment approaches for dissociative disorders, often involving memory recovery, lack robust quantitative outcome data.
  • Experimental research in dissociation is limited and primarily focuses on specific memory functions.

Conclusions:

  • The etiological link between trauma and dissociative disorders, particularly amnesia, is not well-supported by methodologically sound research.
  • There is a need for more rigorous, controlled studies to investigate the causes and effective treatments for dissociative disorders.
  • Depersonalization disorder is identified as a potential area for future diagnostic trends or increased research focus.