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The Diagnosis of Multiple Personality Disorder

A Critical Review

Published online by Cambridge University Press:  02 January 2018

Thomas A. Fahy*
Affiliation:
Bethlem Royal and Maudsley Hospital; Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF

Abstract

Recently, there has been a dramatic rise in the number of case reports of multiple personality disorder (MPD). The phenomenology of the disorder is described and theories on aetiology are discussed. A review of the recent literature reveals a poverty of information on reliability of diagnosis, prevalence, or the role of selection bias. It is argued that iatrogenic factors may contribute to the development of the syndrome. There is little evidence from genetic or physiological studies to suggest that MPD represents a distinct psychiatric disorder. It is assumed that MPD is an hysterical symptom, and an attempt is made to catalogue the predisposing factors and influences that may lead to the clinical presentation.

Type
Review Article
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

American Psychiatric Association (1968) Diagnostic and Statistical Manual of Mental Disorders (2nd edn). Washington, DC: APA.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn). Washington, DC: APA.Google Scholar
Bahnson, C. B. & Smith, K. (1975) Autonomic changes in a multiple personality. Psychosomatic Medicine, 37, 8586.Google Scholar
Benner, D. G. & Joscelyne, B. (1984) Multiple personality as a borderline disorder. Journal of Nervous and Mental Disease, 172, 98104.Google Scholar
Bliss, E. L. (1980) Multiple personalities. A report of 14 cases with implications for schizophrenia and hysteria. Archives of General Psychiatry, 37, 13881397.Google Scholar
Bliss, E. L. (1983) Multiple personalities, related disorders and hypnosis. American Journal of Clinical Hypnosis, 26, 114123.Google Scholar
Bliss, E. L. (1984a) A symptom profile of patients with multiple personalities, including MMPI results. Journal of Nervous and Mental Disease, 172, 197202.Google Scholar
Bliss, E. L. (1984b) Hysteria and hypnosis. Journal of Nervous and Mental Disease, 172, 203206.CrossRefGoogle ScholarPubMed
Bliss, E. L. (1984c) Spontaneous self-hypnosis in multiple personality disorder. Psychiatric Clinics of North America, 7, 135148.CrossRefGoogle ScholarPubMed
Bliss, E. L. (1986) Multiple Personality, Allied Disorders, and Hypnosis. Oxford: Oxford University Press.Google Scholar
Bliss, E. L., Larson, E. M. & Nakashima, S. R. (1983) Auditory hallucinations and schizophrenia. Journal of Nervous and Mental Disease, 171, 3033.Google Scholar
Boor, M. (1982) The Multiple Personality Epidemic. Journal of Nervous and Mental Disease, 170, 302304.Google Scholar
Boor, M. & Coons, P. M. (1983) A comprehensive bibliography of literature pertaining to multiple personality. Psychological Reports, 53, 295310.CrossRefGoogle ScholarPubMed
Bramwell, J. M. (1906) Hypnosis. Its History, Practice and Theory, London: Delamore Press.Google Scholar
Braun, B. G. (1986) Treatment of Multiple Personality Disorder. Washington, DC: American Psychiatric Press.Google Scholar
Buck, O. D. (1983) Multiple personality as a borderline state. Journal of Nervous and Mental Disease, 171, 6265.Google Scholar
Chodoff, P. (1987) More on multiple personality disorder. American Journal of Psychiatry, 144, 124.Google Scholar
Clary, W. F., Burstin, K. J. & Carpenter, J. S. (1984) Multiple personality and borderline personality disorder. Psychiatric Clinics of North America, 7, 8999.Google Scholar
Cocores, J. A., Bender, A. L. & McBride, E. (1984) Multiple personality, seisure disorder and the electroencephalogram. Journal of Nervous and Mental Disease, 172, 436438.Google Scholar
Condon, W. S., Ogston, W. D. & Pacoe, L. V. (1969) Three faces of Eve revisited: a study of transient microstrabismus. Journal of Abnormal Psychology, 74, 618620.Google Scholar
Coons, P. M. (1984) The differential diagnosis of multiple personality disorder. Psychiatric Clinics of North America, 7, 5167.Google Scholar
Coons, P. M. & Milstein, V. (1986) Psychosexual disturbances in multiple personality: Characteristics, etiology, and treatment. Journal of Clinical Psychiatry, 47, 106110.Google Scholar
Coons, P. M., Milstein, V., Marley, C. (1982) EEG studies of two multiple personalities and a control. Archives of General Psychiatry, 39, 823825.Google Scholar
Cooper, L. M. & London, P. (1976) Children's hypnotic susceptibility. International Journal of Clinical and Experimental Hypnosis, 24, 140148.Google Scholar
Cutler, B. & Reed, J. (1975) Multiple personality. A single case study with a 15 year follow-up. Psychological Medicine, 5, 1826.Google Scholar
Damgaard, J., Van Benschoten, S. & Fagen, J. (1985) An updated bibliography of literature pertaining to multiple personality. Psychological Reports, 57, 131137.Google Scholar
Ellenberger, H. F. (1970) The Discovery of the Unconscious. New York: Basic Books.Google Scholar
Erickson, M. H. (1980) The Collected Papers of Milton H. Erickson on Hypnosis, vol. 3, p. 264. New York: Irvington.Google Scholar
Greaves, G. B. (1980) Multiple personality: 165 years after Mary Reynolds. Journal of Nervous and Mental Disease, 168, 577596.Google Scholar
Gruenewald, D. (1971) Hypnotic technique without hypnosis in the treatment of dual personality. Journal of Nervous and Mental Diseases, 153, 4146.Google Scholar
Gruenewald, D. (1977) Multiple personality and splitting phenomena: A reconceptualization. Journal of Nervous and Mental Disease, 164, 385393.Google Scholar
Hanksworth, H. & Schwarz, T. (1977) The Five of Me. New York: Pocket Books.Google Scholar
Harriman, P. L. (1942) The experimental induction of multiple personality. Psychiatry, 5, 179186.CrossRefGoogle Scholar
Harriman, P. L. (1943) A new approach to multiple personality. American Journal of Orthopsychiatry, 13, 638643.Google Scholar
Hilgard, E. R. (1970) Personality and Hypnosis: A Study of Imaginative Involvement. Chicago: University of Chicago Press.Google Scholar
Hogson, R. (1891) A case of double consciousness. Proceedings of the Society for Psychical Research, 7, 221257.Google Scholar
Horevitz, R. P. & Braun, B. G. (1983) Are multiple personality disorder patients borderline? An analysis of 33 patients. Psychiatric Clinics of North America, 7, 6987.Google Scholar
Horton, P. & Miller, D. (1972) The etiology of multiple personality. Comprehensive Psychiatry, 13, 151159.CrossRefGoogle ScholarPubMed
Kampman, R. (1976) Hypnotically induced multiple personality: An experimental study. International Journal of Clinical and Experimental Hypnosis, 3, 215227.Google Scholar
Kernberg, O. F. (1975) Borderline Conditions and Pathological Narcissism. New York: Jason Aronson.Google Scholar
Keyes, D. (1981) The Minds of Billy Milligan. New York: Bantam.Google Scholar
Kluft, R. P. (1982) Varieties of hypnotic interventions in the treatment of multiple personality. American Journal of Clinical Hypnosis, 24, 230240.Google Scholar
Kluft, R. P. (1984) Treatment of multiple personality disorder. Psychiatric Clinics of North America, 7, 929.Google Scholar
Kluft, R. P. (1985a) The natural history of multiple personality disorder. In Childhood Antecedents of Multiple Personality. Washington, DC: American Psychiatric Press.Google Scholar
Kluft, R. P. (1985b) The treatment of multiple personality disorder (MPD): Current concepts. In Directions in Psychiatry (ed. Flach, F. F.). New York: Hatherleigh.Google Scholar
Kluft, R. P. (1987) An update on multiple personality disorder. Hospital and Community Psychiatry, 38, 363373.Google Scholar
Kohlenberg, R. J. (1973) Behavioristic approach to multiple personality: A case study. Behavior Therapy, 4, 137140.Google Scholar
Lasky, R. (1978) The psychoanalytic treatment of a case of multiple personality disorder. Psychoanalytic Review, 65, 353380.Google Scholar
Levin, J. & Fox, J. A. (1985) Mass Murder. New York: Plenum Press.Google Scholar
Larmore, R. J., Ludwig, A. M. & Cain, R. L. (1977) Multiple personality; An objective case study. British Journal of Psychiatry, 131, 3540.Google Scholar
Loewenstein, R. J., Hamilton, J., Algona, S., Reid, N. & deVries, M. (1987) Experiential sampling in the study of multiple personality disorder. American Journal of Psychiatry, 144, 1924.Google Scholar
Lovinger, S. L. (1983) Multiple personality: A theoretical view. Psychotherapy: Research and Practice, 20, 425434.Google Scholar
Ludolph, P. S. (1985) How prevalent is multiple personality. American Journal of Psychiatry, 142, 15261527.Google ScholarPubMed
Ludwig, A. M., Bradsma, J. & Wilbur, C. (1972) The objective study of a multiple personality. Archives of General Psychiatry, 26, 298310.Google Scholar
Macnish, R. (1830) The Philosophy of Sleep. Glasgow: W. R. McPhun.Google Scholar
Major, R. (1974) The revolution of hysteria. International Journal of Psycho-Analysis, 55, 385392.Google Scholar
Margetts, E. L. (1987) Culture bound disorders. Bulletin of the Royal College of Psychiatrists, 11, 275276.Google Scholar
Marmer, S. S. (1980) Psychoanalysis of multiple personality disorder. International Journal of Psychoanalysis, 61, 439459.Google Scholar
Mathews, R. J., Jack, R. A. & West, W. S. (1985) Regional blood flow in a patient with multiple personality. American Journal of Psychiatry, 142, 504505.Google Scholar
Mayo, T. (1845) Case of double consciousness. Medical Gazette, New Series, 1, 12021203.Google Scholar
Mesulam, M. M. (1981) Dissociative states with abnormal temporal lobe EEG. Archives of Neurology, 38, 176181.Google Scholar
Mitchell, S. W. (1888) Mary Reynolds: A case of double consciousness. Transactions of the College of Physicians of Philadelphia (3rd series), 10, 366389.Google Scholar
Mitchill, S. L. (1816) A double consciousness, or duality of person in the same individual. Medical Repository, 3, 185186.Google Scholar
Nash, M. R., Lynn, S. J. & Givens, D. L. (1984) Adult hypnotic susceptibility, childhood punishment, and child abuse: A brief communication. International Journal of Clinical and Experimental Hypnosis, 32, 611.Google Scholar
Nowlis, D. P. (1969) The child-rearing antecedents of hypnotic susceptibility and of naturally occurring hypnotic-like experience. International Journal of Clinical and Experimental Hypnosis, 17, 109120.Google Scholar
Ohne, M. T., Dinges, D. F. & Orne, E. C. (1984) The differential diagnosis of multiple personality disorder in the forensic context. International Journal of Clinical and Experimental Hypnosis, 32, 118167.Google Scholar
Philips, D. P. (1986) Natural experiments on the effects of mass media violence on fatal aggression: Strengths and weaknesses of a new approach. Advances in Experimental Social Psychology, 19, 207250.Google Scholar
Prince, M. (1901) The development and genealogy of the Misses Beauchamp. Proceedings of the Society for Psychical Research, 15, 466483.Google Scholar
Prince, M. (1905) The Dissociation of a Personality. New York: Longmans.Google Scholar
Prince, M. (1920) Miss Beauchamp: The psychogenesis of multiple personality. Journal of Abnormal Psychology, 16, 67137.Google Scholar
Prince, M. & Peterson, F. (1908) Experiments in psychogalvanic reactions from co-conscious ideas in a case of multiple personality. Journal of Abnormal Psychology, 3, 114131.Google Scholar
Putnam, F. W. (1986) The scientific investigation of multiple personality disorder. In Split Minds Split Brains: Historical and Current Perspectives. New York: New York University Press.Google Scholar
Putnam, F. W. (1987) Multiple personality disorder? Journal of Clinical Psychiatry, 48, 174.Google Scholar
Putnam, F. W., Guroff, J. J., Silberman, E. K. Barban, L. & Post, R. M. (1986) The clinical phenomenology of multiple personality disorder: Review of 100 recent cases. Journal of Clinical Psychiatry, 47, 285293.Google Scholar
Rosenbaum, M. (1980) The role of the term schizophrenia in the decline of diagnoses of multiple personality. Archives of General Psychiatry, 37, 13831385.Google Scholar
Saltman, V. & Solomon, R. S. (1982) Incest and the multiple personality. Psychological Reports, 50, 11271141.Google Scholar
Schreiber, F. R. (1973) Sybil. Chicago: Regnery.Google Scholar
Schwartz, J. R. (1981) The Hillside Strangler: A Murderer's Mind. New York: New American Library.Google Scholar
Silberman, E. K., Brandsma, J. M., Wilbur, C. B., Bendfeldt, F. & Post, R. M. (1985) Dissociative states in multiple personality disorder: A quantitative study. Psychiatric Research, 15, 253260.Google Scholar
Skae, D. (1845) Case of intermittent mental disorder of the tertian type, with double consciousness. Northern Journal of Medicine, 4, 1013.Google Scholar
Slater, E. (1965) Diagnosis of hysteria. British Medical Journal, i, 13951399.Google Scholar
Spanos, N. P., Weekes, J. R. & Bertland, L. D. (1985) Multiple personality: A social psychological perspective. Journal of Abnormal Psychology, 94, 362376.CrossRefGoogle ScholarPubMed
Stern, C. R. (1984) The etiology of multiple personalities. Psychiatric Clinics of North America, 7, 150159.Google Scholar
Sutcliffe, J. P. & Jones, J. (1962) Personal identity, multiple personality and hypnosis. International Journal of Clinical and Experimental Hypnosis, 10, 231269.CrossRefGoogle ScholarPubMed
Taylor, W. S. & Martin, M. F. (1944) Multiple personality. Journal of Abnormal and Social Psychology, 39, 281300.CrossRefGoogle Scholar
Thigpen, C. H. & Cleckley, H. (1954) A case of multiple personality. Journal of Abnormal and Social Psychology, 49, 135151.Google Scholar
Thigpen, C. H. & Cleckley, H. (1957) The Three Faces of Eve. London: Seeker and Warburg.Google Scholar
Thigpen, C. H. & Cleckley, H. (1984) On the incidence of multiple personality disorder. International Journal of Clinical and Experimental Hypnosis, 32, 6366.Google Scholar
Wilbur, C. B. (1984) Multiple personality and child abuse. Psychiatric Clinics of North America, 7, 37.Google Scholar
Wilson, S. C. & Barber, T. X. (1982) The fantasy prone personality: Implications for understanding imagery, hypnosis and parapsychological phenomena. In Imagery; Current Theory, Research and Application (ed. Sheikh, A. A.) New York: Wiley.Google Scholar
Work Group To Revise DSM–III (1985) Draft: DSM–III-R in Development 10/5/85. Washington, DC: American Psychiatric Association.Google Scholar
World Health Organization (1987) ICD-10 1986 Draft of Chapter V. Geneva: World Health Organization.Google Scholar
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