Hostname: page-component-55f67697df-zh294 Total loading time: 0 Render date: 2025-05-10T22:50:46.731Z Has data issue: false hasContentIssue false
  • English
  • Français

Multiple Personality Disorder

Published online by Cambridge University Press:  02 January 2018

August Piper Jr
August Piper Jr*
Affiliation:
Providence Hospital, Seattle, Washington, USA; Overlake Hospital, Bellevue, Washington, USA
*
Cabrini Medical Tower, 901 Boren Avenue, Suite 701, Seattle, Washington 98104, USA
Get access Rights & Permissions [Opens in a new window]

Abstract

Five aspects of the diagnosis and treatment of multiple personality disorder (MPD) were examined. The following five conclusions were made: the contemporary diagnostic criteria are vague and overinclusive; the recent alleged increase in prevalence of the disorder is almost certainly artefactual; legal proceedings involving MPD patients raise disturbing questions about personal responsibility; there is little literature support for the theory that MPD results from childhood trauma; and many of the techniques used to diagnose and treat the condition reinforce its symptoms. A careful revision of diagnostic criteria for the disorder is recommended.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 164 , Issue 5 , May 1994 , pp. 600 - 612
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Aldridge-Morris, R. (1989) Multiple Personality: An Exercise in Deception, Ch. I. Hove, United Kingdom: Erlbaum.Google Scholar
Alarcon, R. D. (1990) Pseudomultiplicity: a clinical manifestation of rapid-cycling affective disorder in borderline personality. Annals of Clinical Psychiatry, 2, 127–133.Google Scholar
American Medical Association Council on Scientific Affairs (1985) Scientific status of refreshing recollection by the use of hypnosis. Journal of the American Medical Association, 253, 1918–1923.Google Scholar
American Psychiatric Association (1989a) Treatments of Psychiatric Disorders. Washington, DC: APA.Google Scholar
Anastasi, A. (1988a) Psychological Testing, 6th edn, p. 156. New York: MacMillan.Google Scholar
Anastasi, A. (1988b) Psychological Testing, 6th edn, p. 145. New York: MacMillan.Google Scholar
Bernstein, E. M. & Putnam, F. W. (1986) Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Diseases, 174, 727–735.Google Scholar
Bliss, E. L. (1980) Multiple personalities. Archives of General Psychiatry, 37, 1388–1397.CrossRefGoogle ScholarPubMed
Bliss, E. L. (1984a) A symptom profile of patients with multiple personalities, including MMPI results. Journal of Nervous and Mental Diseases, 172, 197–202.Google Scholar
Bliss, E. L. (1984b) Spontaneous self-hypnosis in multiple personality disorder. Psychiatric Clinics of North America, 7, 135–198.Google Scholar
Bliss, E. L. & Jeppsen, E. A. (1985) Prevalence of multiple personality disorder among inpatients and outpatients. American Journal of Psychiatry, 142, 250–251.Google Scholar
Bonanno, G. A. (1990) Remembering and psychotherapy. Psychotherapy, 27, 175–186.Google Scholar
Bowers, K. S. (1991) Dissociation, hypnosis, and multiple personality disorder. International Journal of Clinical and Experimental Hypnosis, 39, 155–176.Google Scholar
Braun, B. G. (1984) Hypnosis creates multiple personality: myth or reality? International Journal of Clinical and Experimental Hypnosis, 32, 191–197.Google Scholar
Brick, S. S. & Chu, J. A. (1991) The simulation of multiple personalities: a case report. Psychotherapy, 28, 267–272.Google Scholar
Brown, G. R. & Anderson, B. (1991) Psychiatric morbidity in adult inpatients with childhood histories of sexual and physical abuse. American Journal of Psychiatry, 148, 55–61.Google Scholar
Browne, A. & Finkelhor, D. (1986) Impact of child sexual abuse: a review of the research. Psychological Bulletin, 99, 66–77.Google Scholar
Carlin, A. S. & Ward, N. H. (1992) Subtypes of psychiatric inpatient women who have been sexually abused. Journal of Nervous and Mental Diseases, 180, 392–397.Google Scholar
Caul, D. (1984) Group and videotape techniques for multiple personality disorder. Psychiatric Annals, 14, 43–50.CrossRefGoogle Scholar
Chu, J. A. & Dill, D. L. (1990) Dissociative symptoms in relation to childhood physical and sexual abuse. American Journal of Psychiatry, 147, 887–892.Google Scholar
Congdon, M. H., Hain, J. & Stevenson, I. (1961) A case of multiple personality illustrating a transition from role-playing. Journal of Nervous and Mental Diseases, 132, 497–504.Google Scholar
Coons, P. M. (1980) Multiple personality: Diagnostic considerations. Journal of Clinical Psychiatry, 41, 330–336.Google ScholarPubMed
Coons, P. M. (1984) The differential diagnosis of multiple personality. Psychiatric Clinics of North America, 7, 51–67.Google Scholar
Coons, P. M. (1986) Misuse of forensic hypnosis: A hypnotically elicited false confession with the apparent creation of a multiple personality. International Journal of Clinical and Experimental Hypnosis, 36, 1–10.Google Scholar
Coons, P. M. (1991) Iatrogenesis and malingering of multiple personality disorder in the forensic evaluation of homicide defendants. Psychiatric Clinics of North America, 14, 757–768.CrossRefGoogle ScholarPubMed
Coons, P. M. & Milstein, V. (1986) Psychosexual disturbances in multiple personality: characteristics, etiology, treatment. Journal of Clinical Psychiatry, 47, 106–110.Google Scholar
Coons, P. M., Bowman, E. S. & Milstein, V. (1988) Multiple personality disorder: a clinical investigation of 50 cases. Journal of Nervous and Mental Diseases, 176, 519–528.CrossRefGoogle ScholarPubMed
Cutler, B. & Reed, J. (1975) Multiple personality: a single case study with a fifteen year follow-up. Psychological Medicine, 5, 18–26.Google Scholar
Dell, P. F. & Eisenhower, J. W. (1990) Adolescent multiple personality disorder: A preliminary study of eleven cases. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 359–366.Google Scholar
Deyoub, P. L. (1984) Hypnotic stimulation of antisocial behavior: A case report. International Journal of Clinical and Experimental Hypnosis, 32, 301–306.CrossRefGoogle ScholarPubMed
Drake, M. E. (1986) Epilepsy and multiple personality: clinical and EEG findings in 15 cases. Epilepsia, 27, 635.Google Scholar
Fagan, J. & McMahon, P. P. (1984) Incipient multiple personality disorder in children: four cases. Journal of Nervous and Mental Diseases, 84, 26–36.Google Scholar
Fahy, T. A. (1988) The diagnosis of multiple personality disorder: a critical review. British Journal of Psychiatry, 153, 597–606.Google Scholar
Fahy, T. A. (1989) Multiple personality disorder (ltr). British Journal of Psychiatry, 154, 878.Google Scholar
Fahy, T. A., Abas, M., Brown, J. C. (1989) Multiple personality: a symptom of psychiatric disorder. British Journal of Psychiatry, 154, 99–101.Google Scholar
Fichtner, C. G., Kuhlman, D. T., Gruenfeld, M. J., et al (1990) Decreased episodic violence and increased control of dissociation in a carbamazepine-treated case of multiple personality. Biological Psychiatry, 27, 1045–1052.Google Scholar
Fine, C. G. (1991) Treatment stabilization and crisis prevention: pacing the therapy of the MPD patient. Psychiatric Clinics of North America, 14, 661–675.CrossRefGoogle Scholar
Fernando, L. (1991) Multiple personality disorder (ltr). British Journal of Psychiatry, 157, 150.Google Scholar
Frankel, F. H. (1990) Hypnotizability and dissociation. American Journal of Psychiatry, 147, 823–829.Google ScholarPubMed
Franklin, J. (1990) The diagnosis of multiple personality based on subtle dissociative signs. Journal of Nervous and Mental Diseases, 178, 4–14.Google Scholar
Frischholz, E. J., Braun, B. G., Sachs, R. G., et al (1990) The dissociative experiences scale: further replication and validation. Dissociation, 3, 151–153.Google Scholar
Graves, S. G. (1989) Dissociative disorders and dissociative symptoms at a community health centre. Dissociation, 3, 119–127.Google Scholar
Greaves, G. (1980) Multiple personality: 165 years after Mary Reynolds. Journal of Nervous and Mental Diseases, 168, 577–596.Google Scholar
Gruenewald, D. (1971) Hypnotic techniques without hypnosis in the treatment of dual personality. Journal of Nervous and Mental Diseases, 153, 41–46.Google Scholar
Halleck, S. L. (1988) Which patients are responsible for their illnesses? American Journal of Psychotherapy, 42, 338–353.Google Scholar
Halleck, S. L. (1990) Dissociative phenomena and the question of responsibility. International Journal of Clinical and Experimental Hypnosis, 38, 293–314.Google Scholar
Hardy, D. W., Daghestani, A. N. & Egan, W. H. (1988) Multiple personality disorder: failure to diagnose and the potential for malpractice liability. Psychiatric Annals, 18, 543–548.Google Scholar
Harriman, P. L. (1943) A new approach to multiple personalities. American Journal of Orthopsychiatry, 13, 638–643.CrossRefGoogle Scholar
Herzog, A. (1984) On multiple personality: comments on diagnosis, etiology, and treatment. International Journal of Clinical and Experimental Hypnosis, 32, 210–221.Google Scholar
Horevitz, R. P. & Braun, B. G. (1984) Are multiple personalities borderline? Psychiatric Clinics of North America, 7, 69–87.CrossRefGoogle ScholarPubMed
Horton, P. & Miller, D. (1972) The etiology of multiple personality. Comprehensive Psychiatry, 13, 151–159.Google Scholar
Jacobson, A. (1989) Physical and sexual assault histories among psychiatric outpatients. American Journal of Psychiatry, 146, 755–758.Google Scholar
Kemp, K., Gilbertson, A. D. & Torem, M. (1988) The differential diagnosis of multiple personality disorder from borderline personality disorder. Dissociation, 1, 41–46.Google Scholar
Kiser, L. J., Ackerman, B. J., Brown, E., et al (1988) Posttraumatic stress disorder in young children: a reaction to reported sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 645–649.Google Scholar
Kirkland v State (1983) 166 Ga App 478, 304 SE2d 561, 564.CrossRefGoogle Scholar
Kluft, R. P. (1982) Varieties of hypnotic interventions in the treatment of multiple personality. American Journal of Clinical Hypnosis, 24, 230–240.Google Scholar
Kluft, R. P. (1984) Treatment of multiple personality disorder. A study of 33 cases. Psychiatric Clinics of North America, 7, 9–29.Google Scholar
Kluft, R. P. (1985a) The natural history of MPD. In Childhood Antecedents of Multiple Personality (ed. Kluft, R. P.), pp. 198–238. Washington, DC: American Psychiatric Press.Google Scholar
Kluft, R. P. (1985b) Making the diagnosis of multiple personality disorder. Directions in Psychiatry, 5, Lesson 23, 1–11.Google Scholar
Kluft, R. P. (1987a) An update on multiple personality disorder. Hospital and Community Psychiatry, 38, 363–373.Google Scholar
Kluft, R. P. (1987b) The simulation and dissimulation of multiple personality disorder. American Journal of Clinical Hypnosis, 30, 104–118.Google Scholar
Kluft, R. P. (1991) Clinical presentations of multiple personality disorder. Psychiatric Clinics of North America, 14, 605–629.Google Scholar
Leavitt, H. C. (1947) A case of hypnotically produced secondary and tertiary personalities. Psychoanalytic Review, 34, 274–295.Google Scholar
Lewis, D. O. & Bard, J. (1991) Multiple personality and forensic issues. Psychiatric Clinics of North America, 14, 741–756.Google Scholar
Liberman, R. P. & Eckman, T. (1981) Behavior therapy versus insight-oriented therapy for repeated suicide attempters. Archives of General Psychiatry, 38, 1126–1130.Google Scholar
Linehan, M. M., Armstrong, H. E., Suarez, A., et al (1991) Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064.Google Scholar
Loftus, E. F. & Ketcham, K. (1991) Witness for the Defense. New York: St Martin's Press.Google Scholar
Lowenstein, R. J. (1991) An office mental status examination for complex chronic dissociative symptoms and multiple personality disorder. Psychiatric Clinics of North America, 14, 567–604.Google Scholar
Lowenstein, R. J. & Putnam, F. W. (1988) A comparison study of dissociative symptoms in patients with complex partial seizures, MPD, and post-traumatic stress disorder. Dissociation, 1, 17–23.Google Scholar
Ludolph, P. (1985) How prevalent is multiple personality? American Journal of Psychiatry, 142, 1526–1527.Google Scholar
Ludwig, A. M., Brandsma, J. M., Wilbur, C. B., et al (1972) The objective study of a multiple personality. Archives of General Psychiatry, 26, 298–310.Google Scholar
Lynn, S. J., Weekes, J. R. & Milano, M. (1989) Reality versus suggestion pseudomemory in hypnotizable and simulating subjects. Journal of Abnormal Psychology, 98, 137–144.CrossRefGoogle ScholarPubMed
Malenbaum, R. & Russell, A. T. (1987) Multiple personality disorder in an 11-year-old boy and his mother. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 436–439.Google Scholar
Merskey, H. (1992) The manufacture of personalities: the production of multiple personality disorder. British Journal of Psychiatry, 160, 327–340.Google Scholar
Mesulam, M. M. (1981) Dissociative states with abnormal temporal lobe EEG: multiple personality and the illusion of possession. Archives of Neurology, 38, 176–181.Google Scholar
Miller, B. F. & Keane, C. B. (1987) Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, p. 1197. Philadelphia: Saunders.Google Scholar
Modestin, J. (1992) Multiple personality disorder in Switzerland. American Journal of Psychiatry, 149, 88–92.Google Scholar
Moore, M. S. (1984) Law and Psychiatry: Rethinking the Relationship, p. 406. Cambridge: Cambridge University Press.Google Scholar
Nakdimen, K. A. (1990) Multiple personality. Hospital Communications in Psychiatry, 41, 566–567.Google Scholar
Ofshe, R. J. (1992) Inadvertent hypnosis during interrogation: false confession due to dissociative state; mis-identified multiple personality and the satanic cult hypothesis. International Journal of Clinical and Experimental Hypnosis, 40, 125–156.CrossRefGoogle ScholarPubMed
Orne, M. (1979) The use and misuse of hypnosis in court. International Journal of Clinical and Experimental Hypnosis, 27, 311–341.Google Scholar
Pap, A. (1953) Reduction-sentences and open concepts. Methods, 5, 3–30.Google Scholar
Piper, A. (1990) Multiple personality disorder (ltr). Canadian Journal of Psychiatry, 35, 195–196.Google Scholar
Pribor, E. F. & Dinwiddie, S. H. (1992) Psychiatric correlates of incest in childhood. American Journal of Psychiatry, 149, 52–56.Google Scholar
Putnam, F. W. (1984) The psychophysiologic investigation of multiple personality disorder: a review. Psychiatric Clinics of North America, 7, 31–39.Google Scholar
Putnam, F. W. (1989) Diagnosis and Treatment of Multiple Personality Disorder. New York: Guilford.Google Scholar
Putnam, F. W. (1991) Recent research on multiple personality disorder. Psychiatric Clinics of North America, 14, 489–502.Google Scholar
Putnam, F. W. (1992) Multiple personality disorder (ltr). British Journal of Psychiatry, 161, 415–416.Google Scholar
Putnam, F. W., Loewenstein, R. N., Silberman, E. J., et al (1984) Multiple personality disorder in a hospital setting. Journal of Clinical Psychiatry, 45, 172–175.Google Scholar
Putnam, F. W., Guroff, J. J., Silberman, E. K., et al (1986) The clinical phenomenology of multiple personality disorder: review of 100 recent cases. Journal of Clinical Psychiatry, 47, 285–293.Google Scholar
Ross, C. A. (1984) Diagnosis of multiple personality disorder during hypnosis: a case report. International Journal of Clinical and Experimental Hypnosis, 32, 222–235.Google Scholar
Ross, C. A. (1988) Phenomenological overlap of multiple personality disorder and obsessive-compulsive disorder. Journal of Nervous and Mental Diseases, 176, 295–299.Google Scholar
Ross, C. A. (1990a) Twelve cognitive errors about multiple personality disorder. American Journal of Psychotherapy, 44, 348–356.Google Scholar
Ross, C. A. (1990b) Multiple personality disorder (ltr). British Journal of Psychiatry, 156, 449.Google Scholar
Ross, C. A. (1990) Structured interview data on 102 cases of multiple personality disorder from four centers. American Journal of Psychiatry, 147, 596–601.Google Scholar
Ross, C. A. (1991) Epidemiology of multiple personality disorder and dissociation. Psychiatric Clinic of North America, 14, 503–517.Google Scholar
Ross, C. A. & Gahan, P. (1988) Techniques in the treatment of multiple personality disorder. American Journal of Psychotherapy, 42, 40–52.Google Scholar
Ross, C. A., Heber, S., Norton, R., et al (1989a) Differences between multiple personality disorder and other diagnostic groups on structured interview. Journal of Nervous Mental Disorders, 177, 487–491.Google Scholar
Ross, C. A., Heber, S., Norton, R., et al (1989b) Somatic symptoms in multiple personality disorder. Psychosomatics, 20, 154–160.Google Scholar
Ross, C. A., Joshi, S. & Currie, R. (1990) Dissociative experiences in the general population. American Journal of Psychiatry, 147, 1547–1552.Google Scholar
Ross, C. A., Miller, S. D., Bjornson, L., et al (1991) Abuse histories in 102 cases of multiple personality disorder. Canadian Journal of Psychiatry, 36, 97–101.Google Scholar
Ross, C. A., Norton, G. R. & Anderson, G. (1988) The Dissociative Experiences Scale: a replication study. Dissociation, 2, 221–224.Google Scholar
Ross, C. A., Anderson, G., Fleisher, W. P., et al (1992) Dissociative experiences among psychiatric inpatients. General and Hospital Psychiatry, 14, 350–354.Google Scholar
Salkovskis, P. M., Atha, C. & Storer, D. (1990) Cognitive-behavioural problem solving in the treatment of patients who repeatedly attempt suicide. British Journal of Psychiatry, 157, 871–876.Google Scholar
Sandberg, D. A. & Lynn, S. J. (1992) Dissociative experiences, psychopathology and adjustment, and child and adolescent maltreatment in female college students. Journal of Abnormal Psychology, 101, 717–723.CrossRefGoogle ScholarPubMed
Schachter, D. L. (1986) Amnesia and crime: how much do we really know? American Psychologist, 41, 286–295.Google Scholar
Serban, G. (1992) Multiple personality: an issue for forensic psychiatry. American Journal of Psychotherapy, 46, 269–280.CrossRefGoogle ScholarPubMed
Shearer, S. L., Peters, C. P., Quaytman, M. S., et al (1990) Frequency and correlates of childhood sexual and physical abuse histories in adult female borderline inpatients. American Journal of Psychiatry, 147, 214–216.Google Scholar
Sheehan, P. W. (1988) Memory distortion in hypnosis. International Journal of Clinical and Experimental Hypnosis, 36, 296–311.Google Scholar
Sheehan, P. W., Green, V., Truesdale, P. (1992) Influence of rapport on hypnotically induced pseudomemory. Journal of Abnormal Psychology, 101, 690–700.Google Scholar
Silberman, E. K., Putnam, F. W., Weingartner, H., et al (1985) Dissociative states in multiple personality disorder: a quantitative study. Psychiatry Research, 15, 253–260.Google Scholar
Simpson, M. (1989) Multiple personality disorder (ltr). British Journal of Psychiatry, 155, 565.Google Scholar
Smith, V. L., Ellsworth, P. C. (1987) The social psychology of eye-witness accuracy: misleading questions and communicator expertise. Journal of Applied Psychology, 72, 294–300.Google Scholar
Spanos, N. P. (1989) Hypnosis, demonic possession, and multiple personality: Strategic enactments and disavowals of responsibility for actions. In Altered States of Consciousness and Mental Health: A Cross-Cultural Perspective (ed. Ward, A.), pp. 96–125. Newbury Park, CA: Sage.Google Scholar
Spanos, N. P., Weekes, J. R. & Bertrand, L. D. (1985) Multiple personality: a social psychological perspective. Journal of Abnormal Psychology, 94, 362–376.Google Scholar
Spiegel, D. & Cardena, E. (1991) Disintegrated experience: the dissociative disorders revisited. Journal of Abnormal Psychology, 100, 366–378.Google Scholar
Steinberg, M., Rounsaville, B., Cicchetti, D. V. (1990) The structured clinical interview for DSM-III-R dissociative disorders: preliminary report on a new diagnostic instrument. American Journal of Psychiatry, 147, 76–82.Google Scholar
Suengas, A. G. & Johnson, M. K. (1988) Qualitative effects of rehearsal on memories for perceived and imagined events. Journal of Experimental Psychology: General, 117, 377–389.CrossRefGoogle Scholar
Sutcliffe, J. P. & Jones, J. (1962) Personal identity, multiple personality, and hypnosis. International Journal of Clinical and Experimental Hypnosis, 10, 231–269.Google Scholar
Swett, C., Surrey, J. & Cohen, C. (1990) Sexual and physical abuse histories and psychiatric symptoms among male psychiatric outpatients. American Journal of Psychiatry, 147, 632–636.Google Scholar
Swenson, C. (1989) Kernberg and Linehan: Two approaches to the borderline patient. Journal of Personality Disorders, 3, 26–35.Google Scholar
Taylor, W. S. & Martin, M. F. (1944) Multiple personality. Journal of Abnormal and Social Psychology, 49, 135–151.Google Scholar
Terr, L. C. (1989) Debate forum. Resolved: Child sex abuse is overdiagnosed. Journal of the American Academy of Child & Adolescent Psychiatry, 28, 789–797.Google Scholar
Thigpen, C. H. & Cleckley, H. M. (1984) On the incidence of multiple personality disorder: a brief communication. International Journal of Clinical and Experimental Hypnosis, 32, 63–66.Google Scholar
Tozman, S. & Pabis, R. (1989) MPD: Further skepticism (without hostility … we think). Journal of Nervous and Mental Disorders, 177, 708–709.Google Scholar
Wakefield, H. & Underwager, R. (1992) Recovered memories of alleged sexual abuse: lawsuits against parents. Behavioral Sciences and the Law, 10, 483–507.Google Scholar
Weiner, A. (1992) The dissociative experiences scale. American Journal of Psychiatry, 149, 143–144.Google Scholar
Winfield, I., George, L. K., Swartz, M., et al (1990) Sexual assault and psychiatric disorders among a community sample of women. American Journal of Psychiatry, 147, 335–341.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.