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Philip M. Coons - One of the best experts on this subject based on the ideXlab platform.
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Multiple Personality in adolescence: relationship to incestual experiences.
Journal of The American Academy of Child Psychiatry, 2010Co-Authors: Elizabeth S. Bowman, Susanne Blix, Philip M. CoonsAbstract:Children who are physically and/or sexually abused may develop Multiple Personality. Dissociation provides an effective way to cope with the strong affects evoked by abuse and is a predictable defense for young children whose natural development involves fluid role changes as part of fantasy life. This paper presents a case of Multiple Personality in an adolescent and discusses the relationship between abuse and dissociation in children. Guidelines are offered for treatment of an adolescent Multiple Personality.
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Child abuse and Multiple Personality disorder: review of the literature and suggestions for treatment.
Child Abuse & Neglect, 2002Co-Authors: Philip M. CoonsAbstract:The syndrome of Multiple Personality is associated with a high incidence of physical and/or sexual abuse in childhood. Occasionally those with Multiple Personality abuse their own children. Multiple Personality is difficult to diagnose both because of the nature of the syndrome and because of professional reluctance. Although Multiple Personality is most difficult to diagnose during childhood because of the subtlety of the syndrome, the much higher morbidity found in adult cases makes it imperative that it be diagnosed and treated early in order to avoid further abuse and greater morbidity and to shorten treatment time. This review describes the history, clinical features and treatment of Multiple Personality, particularly in children, in addition to exploring the professional reluctance to make the diagnosis.
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Use of the MMPI to distinguish genuine from factitious Multiple Personality disorder.
Psychological Reports, 1993Co-Authors: Philip M. CoonsAbstract:MMPI special scales were repeatedly administered to several Personality states of a woman alleging to have Multiple Personality Disorder. Her inability to produce a consistent response set on retesting helped to unmask a case of factitious Multiple Personality.
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Validity of the dissociative experiences scale in screening for Multiple Personality disorder: A multicenter study
American Journal of Psychiatry, 1993Co-Authors: Eve B. Carlson, Colin A Ross, Philip M. Coons, Frank W Putnam, Richard J. Loewenstein, Moshe S. Torem, Diana L. Dill, Bennett G BraunAbstract:OBJECTIVE The Dissociative Experiences Scale has proved a reliable and valid instrument to measure dissociation in many groups, but its capacity to distinguish patients with Multiple Personality disorder from patients with other psychiatric disorders has not yet been conclusively tested. METHOD A discriminant analysis was performed to classify 1,051 subjects as having or not having Multiple Personality disorder. Another discriminant analysis was performed on a subgroup of 883 subjects more closely representing patients in a typical psychiatric facility in terms of base rates of dissociative disorders. A cutoff score of 30 was also used to classify subjects, and Bayes's theorem, which allows for the calculation of the positive predictive value and the negative predictive value of a screening test, was applied. RESULTS According to discriminant analysis of the total study group, the scale's sensitivity was 76% and its specificity was also 76%; according to discriminant analysis of the more representative subgroup, the scale's sensitivity was 76% and its specificity was 85%. Use of the cutoff score of 30 produced similar results. Results of the application of Bayes's theorem showed that 17% of the subjects scoring 30 or higher would actually have Multiple Personality disorder and 99% of those scoring less than 30 would not have Multiple Personality disorder. CONCLUSIONS These results indicate that the Dissociative Experiences Scale performs quite well as a screening instrument to identify subjects with Multiple Personality disorder. In addition, the consistency of responses to scale items across centers indicates that the symptoms reported by patients with Multiple Personality disorder are highly similar across diverse geographic centers. This consistency supports the reliability and validity of the diagnosis of Multiple Personality disorder across centers.
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Accuracy of the MMPI in Identifying Multiple Personality Disorder
Psychological Reports, 1990Co-Authors: Philip M. Coons, Catherine G. FineAbstract:A number of previous studies have delineated Minnesota Multiphasic Personality Inventory (MMPI) characteristics in patients with Multiple Personality. To test the accuracy of the MMPI in identifying such patients, the authors blindly rated 63 MMPIs as being either Multiple Personality or not. The over-all hit rate for the entire sample was 71 4%, with a 68% hit rate for correctly identified patients with Multiple Personality These hit rates compare favorably with the hit rates in similar studies of other psychiatric disorders and further demonstrate the clinical usefulness of the MMPI in the diagnosis of Multiple Personality.
Colin A Ross - One of the best experts on this subject based on the ideXlab platform.
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Validity of the dissociative experiences scale in screening for Multiple Personality disorder: A multicenter study
American Journal of Psychiatry, 1993Co-Authors: Eve B. Carlson, Colin A Ross, Philip M. Coons, Frank W Putnam, Richard J. Loewenstein, Moshe S. Torem, Diana L. Dill, Bennett G BraunAbstract:OBJECTIVE The Dissociative Experiences Scale has proved a reliable and valid instrument to measure dissociation in many groups, but its capacity to distinguish patients with Multiple Personality disorder from patients with other psychiatric disorders has not yet been conclusively tested. METHOD A discriminant analysis was performed to classify 1,051 subjects as having or not having Multiple Personality disorder. Another discriminant analysis was performed on a subgroup of 883 subjects more closely representing patients in a typical psychiatric facility in terms of base rates of dissociative disorders. A cutoff score of 30 was also used to classify subjects, and Bayes's theorem, which allows for the calculation of the positive predictive value and the negative predictive value of a screening test, was applied. RESULTS According to discriminant analysis of the total study group, the scale's sensitivity was 76% and its specificity was also 76%; according to discriminant analysis of the more representative subgroup, the scale's sensitivity was 76% and its specificity was 85%. Use of the cutoff score of 30 produced similar results. Results of the application of Bayes's theorem showed that 17% of the subjects scoring 30 or higher would actually have Multiple Personality disorder and 99% of those scoring less than 30 would not have Multiple Personality disorder. CONCLUSIONS These results indicate that the Dissociative Experiences Scale performs quite well as a screening instrument to identify subjects with Multiple Personality disorder. In addition, the consistency of responses to scale items across centers indicates that the symptoms reported by patients with Multiple Personality disorder are highly similar across diverse geographic centers. This consistency supports the reliability and validity of the diagnosis of Multiple Personality disorder across centers.
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The frequency of Multiple Personality disorder among psychiatric inpatients.
American Journal of Psychiatry, 1991Co-Authors: Colin A Ross, Geri Anderson, W. P. Fleisher, G. Ron NortonAbstract:OBJECTIVE: A 2-year study was undertaken to determine the frequency of Multiple Personality disorder among general adult psychiatric inpatients. METHOD: All individuals admitted to two 23-bed acute care wards in a teaching hospital in Winnipeg, Man., were screened with the Dissociative Experiences Scale. Individuals with prior diagnoses of Multiple Personality disorder were excluded. All subjects scoring 20 or higher on the Dissociative Experiences Scale were interviewed with the Dissociative Disorders Interview Schedule. Then subjects with a diagnosis of Multiple Personality disorder and comparison subjects were interviewed by a clinician who was blind to all research data. RESULTS: A total of 299 subjects completed the Dissociative Experiences Scale and 80 received a structured diagnostic interview. Ten subjects (3.3%) had clinically confirmed Multiple Personality disorder. CONCLUSIONS: If these results are replicated and accepted, Multiple Personality disorder will become a serious consideration in the differential diagnosis of many psychiatric patients.
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abuse histories in 102 cases of Multiple Personality disorder
The Canadian Journal of Psychiatry, 1991Co-Authors: Colin A Ross, Scott D Miller, Lynda Bjornson, Pamela Reagor, George A Fraser, Geri AndersonAbstract:The authors interviewed 102 individuals with clinical diagnoses of Multiple Personality disorder at four centres using the Dissociative Disorders Interview Schedule. The patients reported high rates of childhood trauma: 90.2% had been sexually abused, 82.4% physically abused, and 95.1% subjected to one or both forms of child abuse. Over 50% of subjects reported initial physical and sexual abuse before age five. The average duration of both types of abuse was ten years, and numerous different perpetrators were identified. Subjects were equally likely to be physically abused by their mothers or fathers. Sexual abusers were more often male than female, but a substantial amount of sexual abuse was perpetrated by mothers, female relatives, and other females. Multiple Personality disorder appears to be a response to chronic trauma originating during a vulnerable period in childhood.
Geri Anderson - One of the best experts on this subject based on the ideXlab platform.
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The frequency of Multiple Personality disorder among psychiatric inpatients.
American Journal of Psychiatry, 1991Co-Authors: Colin A Ross, Geri Anderson, W. P. Fleisher, G. Ron NortonAbstract:OBJECTIVE: A 2-year study was undertaken to determine the frequency of Multiple Personality disorder among general adult psychiatric inpatients. METHOD: All individuals admitted to two 23-bed acute care wards in a teaching hospital in Winnipeg, Man., were screened with the Dissociative Experiences Scale. Individuals with prior diagnoses of Multiple Personality disorder were excluded. All subjects scoring 20 or higher on the Dissociative Experiences Scale were interviewed with the Dissociative Disorders Interview Schedule. Then subjects with a diagnosis of Multiple Personality disorder and comparison subjects were interviewed by a clinician who was blind to all research data. RESULTS: A total of 299 subjects completed the Dissociative Experiences Scale and 80 received a structured diagnostic interview. Ten subjects (3.3%) had clinically confirmed Multiple Personality disorder. CONCLUSIONS: If these results are replicated and accepted, Multiple Personality disorder will become a serious consideration in the differential diagnosis of many psychiatric patients.
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abuse histories in 102 cases of Multiple Personality disorder
The Canadian Journal of Psychiatry, 1991Co-Authors: Colin A Ross, Scott D Miller, Lynda Bjornson, Pamela Reagor, George A Fraser, Geri AndersonAbstract:The authors interviewed 102 individuals with clinical diagnoses of Multiple Personality disorder at four centres using the Dissociative Disorders Interview Schedule. The patients reported high rates of childhood trauma: 90.2% had been sexually abused, 82.4% physically abused, and 95.1% subjected to one or both forms of child abuse. Over 50% of subjects reported initial physical and sexual abuse before age five. The average duration of both types of abuse was ten years, and numerous different perpetrators were identified. Subjects were equally likely to be physically abused by their mothers or fathers. Sexual abusers were more often male than female, but a substantial amount of sexual abuse was perpetrated by mothers, female relatives, and other females. Multiple Personality disorder appears to be a response to chronic trauma originating during a vulnerable period in childhood.
Bennett G Braun - One of the best experts on this subject based on the ideXlab platform.
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Validity of the dissociative experiences scale in screening for Multiple Personality disorder: A multicenter study
American Journal of Psychiatry, 1993Co-Authors: Eve B. Carlson, Colin A Ross, Philip M. Coons, Frank W Putnam, Richard J. Loewenstein, Moshe S. Torem, Diana L. Dill, Bennett G BraunAbstract:OBJECTIVE The Dissociative Experiences Scale has proved a reliable and valid instrument to measure dissociation in many groups, but its capacity to distinguish patients with Multiple Personality disorder from patients with other psychiatric disorders has not yet been conclusively tested. METHOD A discriminant analysis was performed to classify 1,051 subjects as having or not having Multiple Personality disorder. Another discriminant analysis was performed on a subgroup of 883 subjects more closely representing patients in a typical psychiatric facility in terms of base rates of dissociative disorders. A cutoff score of 30 was also used to classify subjects, and Bayes's theorem, which allows for the calculation of the positive predictive value and the negative predictive value of a screening test, was applied. RESULTS According to discriminant analysis of the total study group, the scale's sensitivity was 76% and its specificity was also 76%; according to discriminant analysis of the more representative subgroup, the scale's sensitivity was 76% and its specificity was 85%. Use of the cutoff score of 30 produced similar results. Results of the application of Bayes's theorem showed that 17% of the subjects scoring 30 or higher would actually have Multiple Personality disorder and 99% of those scoring less than 30 would not have Multiple Personality disorder. CONCLUSIONS These results indicate that the Dissociative Experiences Scale performs quite well as a screening instrument to identify subjects with Multiple Personality disorder. In addition, the consistency of responses to scale items across centers indicates that the symptoms reported by patients with Multiple Personality disorder are highly similar across diverse geographic centers. This consistency supports the reliability and validity of the diagnosis of Multiple Personality disorder across centers.
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Rorschach indicators of Multiple Personality Disorder.
Perceptual and Motor Skills, 1992Co-Authors: Susan M. Labott, Bennett G Braun, Frank Leavitt, Roberta G. SachsAbstract:The increase in reported cases of Multiple Personality Disorder underscores a great need to differentiate clearly this from other psychiatric disorders and from simulation of Multiple Personality Disorder. Two sets of Rorschach signs have been advanced as clinical markers by their developers, namely Barach and also Wagner, Allison, and Wagner. As the Wagner signs are prevalent in much of the research on Rorschach responses in Multiple Personality Disorder, the purpose of the present study was to evaluate these signs using Wagner's administration and the resulting Rorschach protocols of 16 Multiple Personality Disorder patients and 16 psychiatric controls. Analysis indicated that this system was deficient in correctly classifying these 32 protocols. A new marker, the Splitting Response, emerged, however, which was more useful. This response, in combination with at least one Dissociative response, produced an accuracy rate of 94%. These new criteria may be useful aids in the detection of Multiple Personality Disorder from Rorschach protocols. Replication is urged.
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Multiple Personality disorder: an overview.
American Journal of Occupational Therapy, 1990Co-Authors: Bennett G BraunAbstract:Multiple Personality disorder is understood today as chronic dissociative psychopathology that most often develops in response to severe abuse in childhood. The dissociative component is a manifestation of a defense mechanism out of control. The person with a biopsychological capacity to dissociate flees inward from overwhelming abuse or feared abuse. When continuing abuse perpetuates dissociations and they are chained by common affective themes, the foundations of Multiple Personality disorder are laid. Although the disorder has its roots in childhood, most patients are not diagnosed with this condition until 20 to 50 years of age. Many have received several prior, erroneous diagnoses of mental or physical disorders or both over a period of 7 or more years. Failure of diagnosis is an indication of the Multiple factors that contribute to making this a covert disorder. Diagnosis and management begin at the same place: the establishment of trust and therapeutic alliance between patient and therapist.
Ralph Slovenko - One of the best experts on this subject based on the ideXlab platform.
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Multiple Personality: perplexities about the law.
Medicine and law, 1995Co-Authors: Ralph SlovenkoAbstract:The challenges that Multiple Personality poses to legal concepts are discussed. They include issues such as consent, competency to stand trial and to testify, defence, criminal responsibility and capacity. The author concludes that the law is based on the idea of a person as a unity and that a person must take responsibility for his or her sub-personalities.
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The Multiple Personality and the criminal law.
Medicine and law, 1993Co-Authors: Ralph SlovenkoAbstract:Multiple Personality disorder (MPD) is a growing phenomenon in the United States. The number of cases have mounted following the celebrated cases of 'Three Faces of Eve' and 'Sybil' that have been popularized over the past several decades. How can--or should--the criminal law deal with Multiple Personality? Should the defendant suffering MPD be deemed competent to stand trial, or be able successfully to assert the insanity defence, or diminished capacity or automatism? Does MPD qualify as a mental disease or defect under the test of criminal responsibility, which would call for commitment upon a finding of not guilty by reason of insanity? What is the effect of MPD on cognition or control? These issues are discussed.