Cross-examining dissociative identity disorder: Neuroimaging and etiology on trial

Abstract

Dissociative identity disorder (DID) is probably the most disputed of psychiatric diagnoses and of psychological forensic evaluations in the legal arena. The iatrogenic proponents assert that DID phenomena originate from psychotherapeutic treatment while traumagenic proponents state that DID develops after severe and chronic childhood trauma. In addition, DID that is simulated with malingering intentions, but not stimulated by psychotherapeutic treatment, may be called pseudogenic. With DID gaining more interest among the general public it can be expected that the number of pseudogenic cases will grow and the need to distinguish between traumagenic, iatrogenic or pseudogenic DID will increase accordingly. This paper discusses whether brain imaging studies can inform the judiciary and/or distinguish the etiology of DID.

Keywords:

• Dissociative identity disorder
• Multiple personality disorder
• Neuroimaging
• Iatrogenic
• Traumagenic
• Pseudogenic
• Etiology
• Aetiology
• Court
• Forensic

A. A. T. S. Reinders is supported by the Netherlands Organization for Scientific Research (www.nwo.nl), NWO-VENI grant no. 451-07-009.

Notes

¹For an extended list of examples of DID in fiction: http://en.wikipedia.org/wiki/DID/MPD_in_fiction

²Phase II is an advanced phase of treatment which involves therapeutic exposure to traumatic memories and allows for self-initiated and self-controlled switching between dissociative identity states.

³Pseudo: fake; falsely; sham; feigned; deceptive resemblance to a specified thing.

Geraerts, E. (2006). Remembrance of things Past: The cognitive psychology of remembering and forgetting trauma. PhD thesis, University of Maastricht.

Huntjens, R. J. C. (2003). Apparent amnesia: Interidentity memory functioning in dissociative identity disorder. PhD thesis, University of Utrecht.

Reinders, A. A. T. S. (2004). Psycho-biological characteristics of dissociative identity disorder: rCBF, physiologic, and subjective findings from a symptom provocation study. In From methods to meaning in functional neuroimaging (pp. 63–93). University Library Groningen, Groningen. PhD thesis.