Brand Bethany L, Sar Vedat, Stavropoulos Pam, Krüger Christa, Korzekwa Marilyn, Martínez-Taboas Alfonso, Middleton Warwick
From Towson University (Dr. Brand); Koç University School of Medicine (Istanbul) (Dr. Sar); Blue Knot Foundation, Sydney, Australia (Dr. Stavropoulos); University of Pretoria (Dr. Krüger); McMaster University (Dr. Korzekwa); Carlos Albizu University (San Juan) (Dr. Martínez-Taboas); Latrobe University, University of New England, University of Canterbury (New Zealand), and University of Queensland (Australia) (Dr. Middleton).
Harv Rev Psychiatry. 2016 Jul-Aug;24(4):257-70. doi: 10.1097/HRP.0000000000000100.
Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertaining to recurrently expressed beliefs regarding DID: (1) belief that DID is a fad, (2) belief that DID is primarily diagnosed in North America by DID experts who overdiagnose the disorder, (3) belief that DID is rare, (4) belief that DID is an iatrogenic, rather than trauma-based, disorder, (5) belief that DID is the same entity as borderline personality disorder, and (6) belief that DID treatment is harmful to patients. The absence of research to substantiate these beliefs, as well as the existence of a body of research that refutes them, confirms their mythical status. Clinicians who accept these myths as facts are unlikely to carefully assess for dissociation. Accurate diagnoses are critical for appropriate treatment planning. If DID is not targeted in treatment, it does not appear to resolve. The myths we have highlighted may also impede research about DID. The cost of ignorance about DID is high not only for individual patients but for the whole support system in which they reside. Empirically derived knowledge about DID has replaced outdated myths. Vigorous dissemination of the knowledge base about this complex disorder is warranted.
分离性身份障碍(DID)是一种复杂的创伤后发育障碍。经过四十年的研究,我们现在有了一个权威的研究基础,但关于该障碍仍存在一些误解和神话,这对患者护理和研究都造成了不利影响。本文审视了与分离性身份障碍反复表达的信念相关的实证文献:(1)认为分离性身份障碍是一种时尚的信念;(2)认为分离性身份障碍主要由北美过度诊断该障碍的专家诊断出来的信念;(3)认为分离性身份障碍很罕见的信念;(4)认为分离性身份障碍是医源性而非基于创伤的障碍的信念;(5)认为分离性身份障碍与边缘型人格障碍是同一实体的信念;(6)认为分离性身份障碍治疗对患者有害的信念。缺乏证实这些信念的研究,以及存在反驳这些信念的大量研究,证实了它们的虚构性质。将这些神话当作事实的临床医生不太可能仔细评估解离情况。准确的诊断对于恰当的治疗规划至关重要。如果在治疗中不针对分离性身份障碍,它似乎不会自行解决。我们所强调的这些神话也可能阻碍对分离性身份障碍的研究。对分离性身份障碍无知的代价不仅对个体患者高昂,对他们所处的整个支持系统也是如此。关于分离性身份障碍的实证性知识已经取代了过时的神话。大力传播关于这种复杂障碍的知识库是有必要的。