Lilienfeld S O, Lynn S J, Kirsch I, Chaves J F, Sarbin T R, Ganaway G K, Powell R A
Department of Psychology, Emory University, Atlanta, Georgia 30322, USA.
Psychol Bull. 1999 Sep;125(5):507-23. doi: 10.1037/0033-2909.125.5.507.
In a recent article in this journal, D. H. Gleaves (1996) criticized the sociocognitive model (SCM; N. P. Spanos, 1994) of dissociative identity disorder (DID) and argued in favor of a posttraumatic model (PTM) in which DID is conceptualized as a consequence of childhood abuse and other traumatic events. The present authors demonstrate that (a) many of Gleaves's arguments were predicated on misunderstandings of the SCM, (b) scrutiny of the evidence regarding the psychopathology and assessment of DID raises questions concerning the PTM's conceptual and empirical underpinnings, (c) the treatment literature suggests that iatrogenic factors play an important role in the etiology of DID, and (d) the evidence linking child abuse to DID is more problematic than implied by Gleaves. The present authors conclude that Gleaves's analysis underemphasized the cultural manifestations of multiple role enactments and that the history of DID imparts a valuable lesson to contemporary psychotherapists.
在本期刊最近的一篇文章中,D. H. 格利夫斯(1996年)批评了分离性身份障碍(DID)的社会认知模型(SCM;N. P. 斯帕诺斯,1994年),并支持一种创伤后模型(PTM),在该模型中,DID被概念化为童年虐待和其他创伤事件的结果。本文作者表明:(a)格利夫斯的许多论点基于对SCM的误解;(b)对有关DID精神病理学和评估的证据进行审查,会引发有关PTM概念和实证基础的问题;(c)治疗文献表明,医源性因素在DID的病因中起重要作用;(d)将儿童虐待与DID联系起来的证据比格利夫斯所暗示的更成问题。本文作者得出结论,格利夫斯的分析没有充分强调多重角色扮演的文化表现,并且DID的历史为当代心理治疗师提供了宝贵的教训。