Summary
Dissociative identity disorder (DID), formerly known as multiple personality disorder, split personality disorder or dissociative personality disorder, is a member of the family of dissociative disorders classified by the DSM-5, DSM-5-TR, ICD-10, ICD-11, and Merck Manual for diagnosis. It remains a controversial diagnosis, despite rigorous study in the scientific literature since 1975. Dissociative identity disorder is characterized by the presence of at least two distinct and relatively enduring personality states. The disorder is accompanied by memory gaps more severe than could be explained by ordinary forgetfulness. The personality states alternately show in a person's behavior; however, presentations of the disorder vary. Other conditions that often occur in people with DID include post-traumatic stress disorder, personality disorders (especially borderline, schizotypal and avoidant), depression, substance use disorders, conversion disorder, somatic symptom disorder, eating disorders, obsessive–compulsive disorder, and sleep disorders. Self-harm, non-epileptic seizures, flashbacks with amnesia for content of flashbacks, anxiety disorders, and suicidality are also common. Genetic and biological factors are believed to play a role. The diagnosis should not be made if the person's condition is better accounted for by substance use disorder, seizures, other medical problems, imaginative play in children, or religious practices. According to the DSM-5-TR, early childhood trauma, typically before the age of ~10 years, can place someone at risk of developing dissociative identity disorder. Across diverse geographic regions, 90% of individuals diagnosed with dissociative identity disorder report experiencing multiple forms of childhood abuse, such as rape, violence, neglect or severe bullying. Other traumatic childhood experiences that have been reported include painful medical or surgical procedures, war, terrorism, attachment disturbance, natural disaster, cult, and occult abuse, loss of a loved one or loved ones, human trafficking, and dysfunctional family dynamics.
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