APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
Child and Adolescent Psychiatric Clinics of North America
ABSTRACT Sought to replicate and extend the findings of the clinical investigators (e.g., P. F. D... more ABSTRACT Sought to replicate and extend the findings of the clinical investigators (e.g., P. F. Dell and J. W. Eisenhower, 1990; J. Fagan and P. P. McMahon, 1984) who have studied dissociative disorders in children and adolescents during the past decade. Of 25 consecutive children and adolescents referred for evaluation to a dissociative disorders clinic between 1984 and 1993, there were 11 with multiple personality disorder, 13 with dissociative disorder not otherwise specified, and one with psychogenic amnesia. Data are presented on the psychiatric history, clinical phenomenology, %DSM- III-R% diagnoses, psychological testing, and dissociation measures in the 4 children, all female (aged 5–12 yrs) and 21 adolescents (aged 13–17 yrs) with dissociative disorders. Each patient was evaluated with a thorough history and mental status examination, using such measures as the Wechsler Intelligence Scale for Children--Revised (WISC--R), the MMPI, and Structured Clinical Interview for Dissociative Disorders. Three case vignettes are described. Severe dissociative disorders appear to be related to childhood trauma and develop increasing complexity as the child matures. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Page 1. THE CROSS·CULTURAL OCCURRENCE OF MPD: ADDITIONAL CASES FROM ARECENT SURVEY Philip M. Coon... more Page 1. THE CROSS·CULTURAL OCCURRENCE OF MPD: ADDITIONAL CASES FROM ARECENT SURVEY Philip M. Coons, MD Elizabeth S. Bowman, MD Richard P. Kluft, MD Victor Milstein, Ph.D. Philip M. Coons, MD, is ...
... Jennifer Radden, Ph.D., Associate Pro-fessor of Philosophy at the University of Massachusetts... more ... Jennifer Radden, Ph.D., Associate Pro-fessor of Philosophy at the University of Massachusetts at Boston is eminently qualified to write this book because of her background in abnormal psychology, so-cial work, and analytical philosophy. ... 2F.3d999 (lOth Cir, 1993). ...
Abstract 1. Summarized major research findings since 1970 with regard to physiologic manifestatio... more Abstract 1. Summarized major research findings since 1970 with regard to physiologic manifestations of multiple personality disorder (MPD), organizing data according to organ systems. These include the neuromuscular, cardiovascular, respiratory, gastrointestinal, ...
Lit tie fol low-up data has been pub lished on in di vid u als with dissociative iden tity dis or... more Lit tie fol low-up data has been pub lished on in di vid u als with dissociative iden tity dis or der (DID). In this study, DID was di agnosed in 25 pa tients by two sea soned dissociative dis or der clinician/researchers be ginning in 1986. The initial evaluationin cludedacomprehensive med i cal and psy chi at ric eval u a tion and Min ne sota Multiphasic Per sonal ity In ven tory (MMPI). A ten-year fol low-up eval u a tion in eluded the Dissociative Experi ences Scale, Ci vil ian Mis sis sippi PTSD Scale, Beck Inventory for De pres sion, Life Ex pe ri ences Sur vey, the MMPI Hypochondriasis scale, and a dissociative dis or ders fol low-up ques tion naire. The pa tients were also asked to write a nar ra tive about their life and treatment since intake. Twelve patients provided follow-up data. Of these twelve, six ul ti mately achieved full in te gra tion of their per son al ity states, although two of them subsequently dissociated into alter personality states again. The two teen-aged pa tients achieved full in te gra tion within two years, while the older pa tients took con sid er ably Ion ger. Of the patients who elected to con tinue in treat ment for their dissociative dis or der and who con tinued to dis so ci ate into al ter per son al ity states, all have experienced major symptomatic improvement in both dissociative and non-dissociative symptomatology. Of the two therapy dropouts, both con tinue to have dissociative symp toms at fol low-up. We con elude that treatmentforDIDfollowingtreatmentguidelinespromulgated by the International Societyforthe Study of Dis so ciation brings about symptomatic im prove merit in both dissociative and non-dissociative symp toms. Ig noring symp toms of dis so ci a tion, as has been ad vo cated by some, resuits in no im prove ment.
The Journal of Nervous and Mental Disease, Dec 1, 1986
Attempts to follow the treatment progress of patients with multiple personality have been limited... more Attempts to follow the treatment progress of patients with multiple personality have been limited to a few single case studies and, in the only large series, to those most successfully treated. This study followed the treatment progress of 20 patients for a mean of 39 months after intake. The study included a detailed history, neurological examination, and psychological testing on each patient. At follow-up each patient was interviewed and a questionnaire was completed by his or her therapist to assess treatment response. Although nine patients achieved partial or full integration, complete integration was maintained by only five. During therapy the unintegrated patients experienced emotional trauma at approximately twice the rate as did the patients who eventually became integrated. Psychodynamic psychotherapy and hypnosis were the most widely prescribed therapies. The improvement in multiple personality appeared to proceed in a stepwise fashion from acceptance of the diagnosis to integration. The progress of therapy was hindered most commonly by the overuse of the mental mechanisms of repression and denial, the continued utilization of secrecy, which began during child abuse, and the production of numerous crises. The most common countertransferences included anger, exasperation, and emotional exhaustion. Although the psychotherapy of patients with multiple personality is tedious and time consuming, it can be eminently successful if the patient and therapist persevere.
Dissociative fugue (formerly psychogenic fugue) is a rare and little understood dissociative diso... more Dissociative fugue (formerly psychogenic fugue) is a rare and little understood dissociative disorder. Following a review of the pertinent literature, five cases of dissociative fugue are described. These cases were systematically studied with a comprehensive history, mental status examination, physical and neurological evaluation, review of previous medical and psychiatric records, and psychological testing including MMPI, WAIS-R, electroencephalogram, and Dissociative Experiences Scale. An unexpected finding was that, in some cases, associated criminal activity may allow the person with dissociative fugue to continue to function in spite of their loss of memory and original identity.
Allhough IMn IuJve~right iUscript;w .studies on patimls with psychogenj€ amnwa between 1935 and 1... more Allhough IMn IuJve~right iUscript;w .studies on patimls with psychogenj€ amnwa between 1935 and 1962, this i5 the fint such study in thirtyJMn. Usingan~tensiwcJinicalhistory, mental sta-tus~amillation, collateral inlerviws, llturological~amillation, electroencephalogram (EEG), intelligence testing, Minnesota Multiphasic Personality Inventory (MMPI), and the Dissociative Expen'ences Scale (DES), the authors examined twenty-five consecutive psychogenic amnesia patients diag1losed with modified DSM-IIl-R criteria. In most cases the amnesia was selective, chronic, and not ojsudden onset. A Jew cases were repetitive. There wert multiple stressJul psychological precipitants. There were many similarities 10 patients with mullipiL personality disorder, providingJurtl1P prooJthat dissociative disorr1erJ occuralbnga dissociatiw spectrum. Psycho~nic amuesia is probably flu most ool1ll1l.on dissociative disorckrdiagnosis. It isJrequently ovnJ..ookM because the sympt.oms an subtk, and other primary diagnom art often preM1lt.
The authors review the co-occurrences of dissociative symptoms and disorders with epilepsy and ps... more The authors review the co-occurrences of dissociative symptoms and disorders with epilepsy and pseudo-seizures and examine newer diagnostic instruments that assist in accurate diagnosis of persons with concomitant seizure behaviors and dissociative symptoms. They also review seizure behaviors and electroencephalographic findings in persons with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS) and dissociative symptoms in persons with epilepsy and with pseudoseizures. Dissociative symptoms in 15 patients with epilepsy and 15 with pseudo-seizures were examined using the Dissociative Experiences Scale (DES) and the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). On the SCID-D, pseudo-seizure patients had significantly higher dissociative symptom scores than epileptic patients, but DES scores did not reliably distinguish epileptic and pseudo-seizure patients. Misdiagnosis of persons with seizures and dissociative symptoms can be avoided by careful adherence to DSM dissociative disorder criteria, the use of video-EEG monitoring, and systematic assessment of dissociative symptoms with the SCID-D.
... 'II. Xo. 2. JlIne 1994 Page 2. Test (Zachary, 1986), and Minnesota Multiphasic Personali... more ... 'II. Xo. 2. JlIne 1994 Page 2. Test (Zachary, 1986), and Minnesota Multiphasic Personality InventoryorMMPI (Hathaway &McKinley, 1967). With their consent all of the inpatients (N=45) had a complete physi-cal and neurological examination and electroencephalogram (EEG). ...
The Journal of Nervous and Mental Disease, Aug 1, 1992
The psychiatric literature generally discourages the use of electroconvulsive therapy (ECT) to tr... more The psychiatric literature generally discourages the use of electroconvulsive therapy (ECT) to treat depression in dissociative disorder patients, but contains little data on outcome. This prospective study of ECT in three dissociative disorder patients demonstrates that ECT is indicated for severe treatment-resistant depression in such patients. Their Hamilton Depression Scale scores fell by 50%, they were remarkably clinically improved, and they maintained their gains for at least 4 months. The ECT proved helpful when depression was felt by most of the active alters rather than just by one depressed personality. Mini-Mental State Examination scores and clinical observation revealed no unusual confusion or side effects from ECT. These patients' dissociated condition was not altered by ECT, which indicates that ECT neither treats nor impairs treatment of dissociation. Electroconvulsive therapy can be helpful in the overall treatment of dissociative disorders by alleviating severe depressions which block utilization of psychotherapy.
... Philip M. Coons, MD Indiana University School ofMedicine Indiananpolis, IN ... It contains tw... more ... Philip M. Coons, MD Indiana University School ofMedicine Indiananpolis, IN ... It contains two chapters written by practicing attorney Wendy Murphy, and by associate law professor Rose Zoltek-Jick describing the legal rights oftrauma victims and the repressed memory ...
Multiple personality is a syndrome characterized by 2 or more alternating personality states and ... more Multiple personality is a syndrome characterized by 2 or more alternating personality states and amnesia. Multiple personality must be differentiated from fugue, possession syndromes, mediumships, hysterical personality, schizophrenia, hypnotic states, organic brain syndrome and simulation. A review of the literature, discussion of diagnosis, and 4 illustrative cases are presented.
ABSTRACT Of 112 consecutive admissions to a dissociative disorders clinic, 11 Ss with symptoms ch... more ABSTRACT Of 112 consecutive admissions to a dissociative disorders clinic, 11 Ss with symptoms characteristic of multiple personality disorder (MPD) ultimately were discovered to have factitious disorder or were malingering. They were compared with 50 MPD Ss previously reported (P. M. Coons et al; see record 1989-08574-001). There were few differences in demographic variables, presenting symptoms, or characteristics of alter personalities between the groups. There was a striking difference, however, between genuine MPD and simulators for the presence of symptoms characteristic of either malingering or factitious disorder. The use of collateral interviews and probing for symptoms common to factitious disorder and malingering are invaluable aids in the differential diagnosis of genuine from simulated MPD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Presents the case of a 25-yr-old woman who was hospitalized after threatening suicide. The S alle... more Presents the case of a 25-yr-old woman who was hospitalized after threatening suicide. The S alleged that she had been the victim of ritual Satanic abuse. A careful evaluation, including history taking, clinical observation, request for collateral information, and psychological testing, failed to corroborate her story and pointed instead to a diagnosis of factitious disorder of the Munchausen type. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
Child and Adolescent Psychiatric Clinics of North America
ABSTRACT Sought to replicate and extend the findings of the clinical investigators (e.g., P. F. D... more ABSTRACT Sought to replicate and extend the findings of the clinical investigators (e.g., P. F. Dell and J. W. Eisenhower, 1990; J. Fagan and P. P. McMahon, 1984) who have studied dissociative disorders in children and adolescents during the past decade. Of 25 consecutive children and adolescents referred for evaluation to a dissociative disorders clinic between 1984 and 1993, there were 11 with multiple personality disorder, 13 with dissociative disorder not otherwise specified, and one with psychogenic amnesia. Data are presented on the psychiatric history, clinical phenomenology, %DSM- III-R% diagnoses, psychological testing, and dissociation measures in the 4 children, all female (aged 5–12 yrs) and 21 adolescents (aged 13–17 yrs) with dissociative disorders. Each patient was evaluated with a thorough history and mental status examination, using such measures as the Wechsler Intelligence Scale for Children--Revised (WISC--R), the MMPI, and Structured Clinical Interview for Dissociative Disorders. Three case vignettes are described. Severe dissociative disorders appear to be related to childhood trauma and develop increasing complexity as the child matures. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Page 1. THE CROSS·CULTURAL OCCURRENCE OF MPD: ADDITIONAL CASES FROM ARECENT SURVEY Philip M. Coon... more Page 1. THE CROSS·CULTURAL OCCURRENCE OF MPD: ADDITIONAL CASES FROM ARECENT SURVEY Philip M. Coons, MD Elizabeth S. Bowman, MD Richard P. Kluft, MD Victor Milstein, Ph.D. Philip M. Coons, MD, is ...
... Jennifer Radden, Ph.D., Associate Pro-fessor of Philosophy at the University of Massachusetts... more ... Jennifer Radden, Ph.D., Associate Pro-fessor of Philosophy at the University of Massachusetts at Boston is eminently qualified to write this book because of her background in abnormal psychology, so-cial work, and analytical philosophy. ... 2F.3d999 (lOth Cir, 1993). ...
Abstract 1. Summarized major research findings since 1970 with regard to physiologic manifestatio... more Abstract 1. Summarized major research findings since 1970 with regard to physiologic manifestations of multiple personality disorder (MPD), organizing data according to organ systems. These include the neuromuscular, cardiovascular, respiratory, gastrointestinal, ...
Lit tie fol low-up data has been pub lished on in di vid u als with dissociative iden tity dis or... more Lit tie fol low-up data has been pub lished on in di vid u als with dissociative iden tity dis or der (DID). In this study, DID was di agnosed in 25 pa tients by two sea soned dissociative dis or der clinician/researchers be ginning in 1986. The initial evaluationin cludedacomprehensive med i cal and psy chi at ric eval u a tion and Min ne sota Multiphasic Per sonal ity In ven tory (MMPI). A ten-year fol low-up eval u a tion in eluded the Dissociative Experi ences Scale, Ci vil ian Mis sis sippi PTSD Scale, Beck Inventory for De pres sion, Life Ex pe ri ences Sur vey, the MMPI Hypochondriasis scale, and a dissociative dis or ders fol low-up ques tion naire. The pa tients were also asked to write a nar ra tive about their life and treatment since intake. Twelve patients provided follow-up data. Of these twelve, six ul ti mately achieved full in te gra tion of their per son al ity states, although two of them subsequently dissociated into alter personality states again. The two teen-aged pa tients achieved full in te gra tion within two years, while the older pa tients took con sid er ably Ion ger. Of the patients who elected to con tinue in treat ment for their dissociative dis or der and who con tinued to dis so ci ate into al ter per son al ity states, all have experienced major symptomatic improvement in both dissociative and non-dissociative symptomatology. Of the two therapy dropouts, both con tinue to have dissociative symp toms at fol low-up. We con elude that treatmentforDIDfollowingtreatmentguidelinespromulgated by the International Societyforthe Study of Dis so ciation brings about symptomatic im prove merit in both dissociative and non-dissociative symp toms. Ig noring symp toms of dis so ci a tion, as has been ad vo cated by some, resuits in no im prove ment.
The Journal of Nervous and Mental Disease, Dec 1, 1986
Attempts to follow the treatment progress of patients with multiple personality have been limited... more Attempts to follow the treatment progress of patients with multiple personality have been limited to a few single case studies and, in the only large series, to those most successfully treated. This study followed the treatment progress of 20 patients for a mean of 39 months after intake. The study included a detailed history, neurological examination, and psychological testing on each patient. At follow-up each patient was interviewed and a questionnaire was completed by his or her therapist to assess treatment response. Although nine patients achieved partial or full integration, complete integration was maintained by only five. During therapy the unintegrated patients experienced emotional trauma at approximately twice the rate as did the patients who eventually became integrated. Psychodynamic psychotherapy and hypnosis were the most widely prescribed therapies. The improvement in multiple personality appeared to proceed in a stepwise fashion from acceptance of the diagnosis to integration. The progress of therapy was hindered most commonly by the overuse of the mental mechanisms of repression and denial, the continued utilization of secrecy, which began during child abuse, and the production of numerous crises. The most common countertransferences included anger, exasperation, and emotional exhaustion. Although the psychotherapy of patients with multiple personality is tedious and time consuming, it can be eminently successful if the patient and therapist persevere.
Dissociative fugue (formerly psychogenic fugue) is a rare and little understood dissociative diso... more Dissociative fugue (formerly psychogenic fugue) is a rare and little understood dissociative disorder. Following a review of the pertinent literature, five cases of dissociative fugue are described. These cases were systematically studied with a comprehensive history, mental status examination, physical and neurological evaluation, review of previous medical and psychiatric records, and psychological testing including MMPI, WAIS-R, electroencephalogram, and Dissociative Experiences Scale. An unexpected finding was that, in some cases, associated criminal activity may allow the person with dissociative fugue to continue to function in spite of their loss of memory and original identity.
Allhough IMn IuJve~right iUscript;w .studies on patimls with psychogenj€ amnwa between 1935 and 1... more Allhough IMn IuJve~right iUscript;w .studies on patimls with psychogenj€ amnwa between 1935 and 1962, this i5 the fint such study in thirtyJMn. Usingan~tensiwcJinicalhistory, mental sta-tus~amillation, collateral inlerviws, llturological~amillation, electroencephalogram (EEG), intelligence testing, Minnesota Multiphasic Personality Inventory (MMPI), and the Dissociative Expen'ences Scale (DES), the authors examined twenty-five consecutive psychogenic amnesia patients diag1losed with modified DSM-IIl-R criteria. In most cases the amnesia was selective, chronic, and not ojsudden onset. A Jew cases were repetitive. There wert multiple stressJul psychological precipitants. There were many similarities 10 patients with mullipiL personality disorder, providingJurtl1P prooJthat dissociative disorr1erJ occuralbnga dissociatiw spectrum. Psycho~nic amuesia is probably flu most ool1ll1l.on dissociative disorckrdiagnosis. It isJrequently ovnJ..ookM because the sympt.oms an subtk, and other primary diagnom art often preM1lt.
The authors review the co-occurrences of dissociative symptoms and disorders with epilepsy and ps... more The authors review the co-occurrences of dissociative symptoms and disorders with epilepsy and pseudo-seizures and examine newer diagnostic instruments that assist in accurate diagnosis of persons with concomitant seizure behaviors and dissociative symptoms. They also review seizure behaviors and electroencephalographic findings in persons with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS) and dissociative symptoms in persons with epilepsy and with pseudoseizures. Dissociative symptoms in 15 patients with epilepsy and 15 with pseudo-seizures were examined using the Dissociative Experiences Scale (DES) and the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). On the SCID-D, pseudo-seizure patients had significantly higher dissociative symptom scores than epileptic patients, but DES scores did not reliably distinguish epileptic and pseudo-seizure patients. Misdiagnosis of persons with seizures and dissociative symptoms can be avoided by careful adherence to DSM dissociative disorder criteria, the use of video-EEG monitoring, and systematic assessment of dissociative symptoms with the SCID-D.
... 'II. Xo. 2. JlIne 1994 Page 2. Test (Zachary, 1986), and Minnesota Multiphasic Personali... more ... 'II. Xo. 2. JlIne 1994 Page 2. Test (Zachary, 1986), and Minnesota Multiphasic Personality InventoryorMMPI (Hathaway &McKinley, 1967). With their consent all of the inpatients (N=45) had a complete physi-cal and neurological examination and electroencephalogram (EEG). ...
The Journal of Nervous and Mental Disease, Aug 1, 1992
The psychiatric literature generally discourages the use of electroconvulsive therapy (ECT) to tr... more The psychiatric literature generally discourages the use of electroconvulsive therapy (ECT) to treat depression in dissociative disorder patients, but contains little data on outcome. This prospective study of ECT in three dissociative disorder patients demonstrates that ECT is indicated for severe treatment-resistant depression in such patients. Their Hamilton Depression Scale scores fell by 50%, they were remarkably clinically improved, and they maintained their gains for at least 4 months. The ECT proved helpful when depression was felt by most of the active alters rather than just by one depressed personality. Mini-Mental State Examination scores and clinical observation revealed no unusual confusion or side effects from ECT. These patients' dissociated condition was not altered by ECT, which indicates that ECT neither treats nor impairs treatment of dissociation. Electroconvulsive therapy can be helpful in the overall treatment of dissociative disorders by alleviating severe depressions which block utilization of psychotherapy.
... Philip M. Coons, MD Indiana University School ofMedicine Indiananpolis, IN ... It contains tw... more ... Philip M. Coons, MD Indiana University School ofMedicine Indiananpolis, IN ... It contains two chapters written by practicing attorney Wendy Murphy, and by associate law professor Rose Zoltek-Jick describing the legal rights oftrauma victims and the repressed memory ...
Multiple personality is a syndrome characterized by 2 or more alternating personality states and ... more Multiple personality is a syndrome characterized by 2 or more alternating personality states and amnesia. Multiple personality must be differentiated from fugue, possession syndromes, mediumships, hysterical personality, schizophrenia, hypnotic states, organic brain syndrome and simulation. A review of the literature, discussion of diagnosis, and 4 illustrative cases are presented.
ABSTRACT Of 112 consecutive admissions to a dissociative disorders clinic, 11 Ss with symptoms ch... more ABSTRACT Of 112 consecutive admissions to a dissociative disorders clinic, 11 Ss with symptoms characteristic of multiple personality disorder (MPD) ultimately were discovered to have factitious disorder or were malingering. They were compared with 50 MPD Ss previously reported (P. M. Coons et al; see record 1989-08574-001). There were few differences in demographic variables, presenting symptoms, or characteristics of alter personalities between the groups. There was a striking difference, however, between genuine MPD and simulators for the presence of symptoms characteristic of either malingering or factitious disorder. The use of collateral interviews and probing for symptoms common to factitious disorder and malingering are invaluable aids in the differential diagnosis of genuine from simulated MPD. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Presents the case of a 25-yr-old woman who was hospitalized after threatening suicide. The S alle... more Presents the case of a 25-yr-old woman who was hospitalized after threatening suicide. The S alleged that she had been the victim of ritual Satanic abuse. A careful evaluation, including history taking, clinical observation, request for collateral information, and psychological testing, failed to corroborate her story and pointed instead to a diagnosis of factitious disorder of the Munchausen type. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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