Split Sciences: The Legal Accountability of Patients With Dissociative Identity Disorder

The thriller “Split” by M. Night Shyamalan showed a glimpse into the multiple personalities of the antagonist in the film. While many elements were added for intense suspense, the existence of such a disorder was factual. Dissociative Identity Disorder is defined by the American Psychiatric Association as a “psychological illness with 2 or more distinct identities, each accompanied by changes in behavior, memory, and thinking” (American Psychiatric Association). In a legal setting, the actions of the patients with DID have numerous ramifications. This paper aims to illustrate how the accountability of DID patients during a crime should be assessed. To find out how DID patients could be held accountable, we analyzed the disorder by researching the transformations in the brain, identified its origins, and explored the consequences in a judicial milieu. After conducting this research, we identified the solution that could be seamlessly embedded into our current society and benefit the patient as well as the courts. Through the analysis of the psychological disorder with a social lens, we evaluated that the jury and the public should be made more aware of the disorder and the court should not automatically assume innocence based on just the Insanity Defense. This plan is the best course of action for patients and the court systems and also aims to adapt societal thought to be more aware of DID’s difficulties.

Dissociative Disorder in the Iranian Culture: The Lawless Utopia

Epidemiologic and etiological studies of dissociative disorders are a challenging area in psychiatry. These challenges become more complex when noting that the existing theories cannot explain the differences observed in certain cases; for example, studies in Iran have reported the prevalence of dissociative disorders (dissociative amnesia, dissociative fugue, and depersonalization disorder) as less than 0.6%, and there has been no reported case of dissociative identity disorder (DID) in this country; meanwhile, the prevalence of all dissociative disorders in the general population of the US has been reported as 18.3%, and the prevalence of DID as about 1.1%. Although several studies indicate the high prevalence of dissociative symptoms in many Iranian psychiatric illnesses, dissociative disorders as a stand-alone disorder have a very low prevalence in Iran. The present article attempts to propose a possible hypothesis for the answer to the above questions through a different cultural conceptualization and seeks to be of some help to future studies in this area. Certainly, this hypothesis requires a careful study to be validated.

A neurostructural biomarker of dissociative amnesia: a hippocampal study in dissociative identity disorder

Background Little is known about the neural correlates of dissociative amnesia, a transdiagnostic symptom mostly present in the dissociative disorders and core characteristic of dissociative identity disorder (DID). Given the vital role of the hippocampus in memory, a prime candidate for investigation is whether total and/or subfield hippocampal volume can serve as biological markers of dissociative amnesia. Methods A total of 75 women, 32 with DID and 43 matched healthy controls (HC), underwent structural magnetic resonance imaging (MRI). Using Freesurfer (version 6.0), volumes were extracted for bilateral global hippocampus, cornu ammonis (CA) 1–4, the granule cell molecular layer of the dentate gyrus (GC-ML-DG), fimbria, hippocampal−amygdaloid transition area (HATA), parasubiculum, presubiculum and subiculum. Analyses of covariance showed volumetric differences between DID and HC. Partial correlations exhibited relationships between the three factors of the dissociative experience scale scores (dissociative amnesia, absorption, depersonalisation/derealisation) and traumatisation measures with hippocampal global and subfield volumes. Results Hippocampal volumes were found to be smaller in DID as compared with HC in bilateral global hippocampus and bilateral CA1, right CA4, right GC-ML-DG, and left presubiculum. Dissociative amnesia was the only dissociative symptom that correlated uniquely and significantly with reduced bilateral hippocampal CA1 subfield volumes. Regarding traumatisation, only emotional neglect correlated negatively with bilateral global hippocampus, bilateral CA1, CA4 and GC-ML-DG, and right CA3. Conclusion We propose decreased CA1 volume as a biomarker for dissociative amnesia. We also propose that traumatisation, specifically emotional neglect, is interlinked with dissociative amnesia in having a detrimental effect on hippocampal volume.

Assessing malingering in dissociative identity disorder: A case report and literature review

Dissociative identity disorder (DID), formerly known as multiple personality disorder, is characterised by two or more identities that control a patient’s actions, each typically with a distinct personal history, self-awareness, and name. They are believed to be the result of trauma-related dissociative defence mechanisms. Substantial progress has been made to determine the cognitive, neural, and psychometric signatures of dissociative identities. However, tools to discriminate genuine DID individuals from malingerers are still lacking. Here, we review the empirical attempts that have been made to detect malingerers of DID. Additionally, we present the case of a DID patient who exhibited nine different identities. After clinically ruling out malingering and factitious behaviour, we assessed her primary identity and two alternate identities (a trauma identity and an avoidant identity) using the Millon Index of Personality Styles. We found three very distinct personality profiles, with evident differences between primary and trauma identities. The profiles had high consistency scores and moderate to low negative and positive impression scores, respectively, thus supporting the profile’s validity for interpretation. Future studies should employ personality inventories that go beyond psychopathological symptoms to describe the consistency and adaptation style of dissociative identities when assessing malingering.

Dua Sisi Kepribadian Bertolak Belakang: Psikoanalisis Freudian dalam Novel Deviasi Karya Mira W

Abstrak Teori Psikoanalisis Freud bukan saja digunakan untuk terapi pada manusia, akan tetapi sering juga digunakan untuk menelaah karya sastra yang memuat masalah-masalah psikologis tokoh yang ada di dalam karya sastra. Sigmund Freud dikenal dengan teorinya mengenai lapisan kesadaran, dan ia sendiri mengujicobakan teorinya mengenai lapisan kesadaran ini ke dalam karya sastra. Tujuan penulisan ini adalah untuk menelaah tokoh yang mengalami penyimpangan secara kejiwaan dalam novel karya Mira W. yang berjudul Deviasi dengan menggunakan teori dan pendekatan psikoanalisis Freud dalam karya sastra. Hasil analisis memperlihatkan bahwa tokoh utama dalam novel ini mengalami masalah kejiwaan berat sehingga menderita Dissociative Identity Disorder(DID) atau Multiple Personality Disorder, yakni suatu kelainan kejiwaan yang mengakibatkan seseorang memiliki kepribadian ganda. Kelainan kejiwaan ini tidak muncul begitu saja, akan tetapi ada sebuah penyebab yang berasal dari masa kanak-kanak dan butuh rentangan waktu yang panjang untuk memperlihatkan bahwa seseorang telah menyimpang secara kejiwaan, atau tidak norma Abstract Freud’s Psychoanalytic Theory is not only used for therapy in humans, but often also used to examine literary works that contain psychological problems of characters inside literary works. Sigmund Freud was known for his theory of the layer of consciousness, and he tested his theory into literary work. The purpose of this paper is to examine the characters who experience psychiatric disorder in Mira W's novel entitled Deviasi using Freud's psychoanalytic theory and approach in literary works. The results of the analysis show that the main character in this novel suffered severe psychiatric problems and he had suffered of Dissociative Identity Disorder (DID) or Multiple Personality Disorder, a psychiatric disorder that results in a person having multiple personalities. This psychiatric disorder does not appear just in sudden, but there is a cause that originates from childhood and requires a long stretch of time to show that someone has psychological disorder or abnormally deviated.