DSM-5: Dissociative Identity Disorder

I. Dissociative Disorders

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was released May 18, 2013 after years of discourse by experts in specific areas. The contributors are volunteers who felt strongly about the subject they contributed to. Others, who consider themselves to be experts, but who were not willing to volunteer their time, did not get the outcome they desired. Overall the manual performs its function, which is to determine a label for a given set of symptoms.

The DSM criteria and explanations listed here are not meant to self-diagnose, but instead are meant to help improve the publics understanding of dissociative identity disorder and to a lesser extent, OSDD. A trauma specialist with experience and training in the Dissociative Disorders should be contacted if you suspect you have any Dissociative Disorder. Many mental health professionals lack the training needed to recognize and treat this class of disorders.

II. Diagnostic and Statistical Manual of Mental Disorders DSM-5 (300.14) criteria for dissociative identity disorder

 Disruption of identity characterized by two or more distinct personality parts. This disruption may be observed by others, or reported by the patient.

 True amnesia, rather than just dissociative amnesia.

 The disturbance is not a normal part of broadly accepted cultural, religious practice, or part of the normal fantasy play of children.

The last two points are commonly stressed with any mental illness.

 Causes clinically significant distress and impairment in social, occupational, or other important areas of functioning.

 The disturbance is not due to the direct physiological effects of a substance. 

The DSM-5, research, college text-books, and expert written books are all used for references and to better understand a disorder, however some are better than others. The DSM is not meant to be used to describe, define or to understand a disorder, but instead is a list of the simplest and easiest symptoms that a therapist can discern in a therapeutic setting in order to understand the mental illness a client might have. Research articles are intended as a means for researchers to comment, combine and work together to find common ground. Text books meant for college level classes and below, and they are a combination of old ideas that are what the mainstream public tend to believe. In order to get the most current, working concept of a mental disorder, it’s best to find the top researchers on a topic and read their work. In the case of dissociative identity disorder, in 2015, that is Onno van der Hart, Ellert Nijenhuis,Ulrich Lanius, Sandra Paulsen, Frank Corrigan, Allan Schore, Bessel van der Kolk, David Mann, George Northoff, Robert Stickgold, Grigoris Vaslamatzis, Matthew Walker and edited by Giuseppe Leo and select others with either like ideas or even more forward thinking.

III. History of the Diagnostic and Statistical Manual of Mental Disorders-5

The Diagnostic and Statistical Manual of Mental Disorders-I was published in 1952, followed in 1968 by the DSM II. The DSM III was published in 1980, and the DSM-IV in 1994. The most current version is the DSM-5 was released in May, 2013.

Changes from the DSM I to the DSM II

The first time there was mention of “multiple personalities” in the DSM was in volume II under the heading of Neuroses (300). On page 39, are the subheadings including “hysterical neurosis conversion type (300.13).” As a subheading under this was “hysterical neurosis dissociative type (300.14) which was described as “In the dissociative type, alterations may occur in the patient’s state of consciousness or in his identity, to produce such symptoms as amnesia, somnambulism, fugue and multiple personalities.

Changes from the DSM I to the DSM II 
It was in 1980 that multiple personality disorder was finally recognized as a condition on it’s own. The DSM-III changed multiple personalities from a symptom of “hysterical neurosis conversion type to it’s own diagnosis which they called multiple personality disorder.

Changes from the DSM-IV to the DSM-5
The following changes to the DSM-IV were suggested by the DSM-5 work committee.

  1. Clarification of language.
  2. Different states can be reported or observed. Including trance and possession.
  3. Mention of experience of possession increases global utility.
  4. Amnesia for everyday events is a common feature.
  5. Differentiate normative cultural experiences from psychopathology. (Siegel 2011)