Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Department of Psychiatry, Amsterdam UMC, Location VUmc, VU University Amsterdam, Amsterdam, The Netherlands.
Brain Behav. 2023 Oct;13(10):e3208. doi: 10.1002/brb3.3208. Epub 2023 Sep 18.
Dissociative identity disorder (DID) is characterized by, among others, amnesic episodes and the recurrence of different dissociative identity states. While consistently observed in clinical settings, to our knowledge, no controlled research study has shown the degree to which different identity states report autobiographical knowledge over time. Hence, the current study investigates self-relevance and emotional intensity ratings of words longitudinally.
Data of 46 participants were included: 13 individuals with DID, 11 DID-simulating actors, and a control group of 22 paired individuals. Individuals with DID and DID simulators participated once in the neutral identity state (NIS) and once in the trauma-related dissociative identity state (TIS). The control group paired 11 healthy controls with 11 participants with posttraumatic stress disorder (PTSD) as a NIS-TIS pair. Self-relevance ratings of different word types were collected in a baseline and a follow-up session, on average 6 weeks apart. A mixed ANOVA design was used to assess the effects of group, session, word type, and dissociative identity state.
All participants in TIS and individuals with DID in NIS rated self-relevant trauma-related words more negatively. In the NIS, the control group rated self-relevant trauma-related words as less negative, whereas the ratings of simulating actors were intermediate. There was no group-dependent longitudinal effect for intensity ratings.
This study was the first to confirm clinical observations that self-relevant and emotional processing are different between individuals with DID and controls, but consistent over time. Actors were unable to perfectly simulate DID. The finding that ratings of self-relevant trauma-related words differ between subgroups as included in the study is in line with clinical observations.
分离性身份障碍（DID）的特征包括健忘症发作和不同分离性身份状态的反复出现。虽然在临床环境中一直观察到，但据我们所知，没有对照研究表明不同身份状态随时间报告自传体知识的程度。因此，目前的研究从纵向角度调查了自我相关性和情感强度评分。
共纳入 46 名参与者：13 名 DID 患者、11 名 DID 模拟演员和 22 名配对的对照组个体。DID 患者和 DID 模拟演员各参加一次中性身份状态（NIS）和一次与创伤相关的分离性身份状态（TIS）。对照组将 11 名健康对照者与 11 名创伤后应激障碍（PTSD）患者配对，作为 NIS-TIS 配对。在基线和随访期间，平均间隔 6 周，收集不同类型词语的自我相关性评分。采用混合方差分析设计来评估组、会话、词语类型和分离性身份状态的影响。
TIS 中的所有参与者和 NIS 中的 DID 患者对自我相关的创伤相关词语的评价更为负面。在 NIS 中，对照组对自我相关的创伤相关词语的评价不那么负面，而模拟演员的评价则处于中间位置。强度评分没有组间的纵向效应。
这项研究首次证实了临床观察结果，即 DID 患者和对照组的自我相关性和情感处理不同，但随时间保持一致。演员无法完美模拟 DID。研究中纳入的亚组之间自我相关的创伤相关词语评分的差异与临床观察一致。
