Talk:Dissociative identity disorder/Archive 12

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Joel Paris has been greatly disputed if not discredited

hi, i find some of the language biased, such as the word "bizarre" in two places, and two sections referencing J Paris who is dismissive of DID and has been countered with more recent articles. https://www.ncbi.nlm.nih.gov/pubmed/23538984

The links I added to an article by a DSM writer and a research page have useful information, why are they removed but Curlie site links which are a mix of science and non science, is ok?

Also this paragraph seems random and not particularly useful...?

       In a 1986 book chapter (later reprinted in another volume), philosopher of science Ian Hacking focused on multiple personality disorder as an example of "making up people" through the untoward effects on individuals of the "dynamic nominalism" in medicine and psychiatry. With the invention of new terms entire new categories of "natural kinds" of people are assumed to be created, and those thus diagnosed respond by re-creating their identity in light of the new cultural, medical, scientific, political and moral expectations. Hacking argued that the process of "making up people" is historically contingent, hence it is not surprising to find the rise, fall, and resurrection of such categories over time.[95] Hacking revisited his concept of "making up people" in an article published in the London Review of Books on 17 August 2006.[96]

thanks

Emstason (talk) 01:07, 1 April 2018 (UTC)

Referencing Colin Ross in the controversy subsection

While he is, indeed, a strong proponent of the DID diagnosis as a real entity (as opposed to being an iatrogenic artifact), is the unqualified referencing Colin Ross as an authority appropriate and meeting the standards for Wikipedia articles for credible sources? Colin Ross is, without a doubt, a crackpot and conspiracy theory monger. See, for instance, https://greyfaction.org/colin-ross/ and https://vimeo.com/1449829?pg=embed&sec=1449829 . — Preceding unsigned comment added by Cosmicaug (talk • contribs) 18:48, 2 January 2019 (UTC)

"Split personality"

Doczilla, regarding this and this, what is the "something else" you are referring to? The reason that "split personality" redirects here is because dissociative identity disorder is what people usually mean when they state "split personality." It's just that they usually have not heard of the term "dissociative identity disorder" and don't understand the topic. The "Society and culture" section could address the "split personality" term. As for "split personality disorder," which also redirects here, I'm not sure about how to cover that term in this article. If you reply to me on this, as I ask that you don't WP:Ping me since this article is on my watchlist. Flyer22 Reborn (talk) 06:31, 8 January 2019 (UTC)

Frequency

The ref says "In studies of the general population, a prevalence rate of DID of 1% to 3% of the population has been described"[1] Can be summarized as about 2 % Doc James (talk · contribs · email) 04:17, 7 February 2019 (UTC)

1.5% is about 2% thus also supported by the DSM5 Doc James (talk · contribs · email) 04:19, 7 February 2019 (UTC)

The same source that says 1-3% also calls the disorder "relatively common" when neither 1.5% nor 2% is common. It's selectively citing studies in the 1-3% range there. Other sources contradict those figures, ranging widely. Obviously I should cite the contradictory sources if I want to push this. If I weren't busy writing a psychology book right now, I would, so I have to let this issue go. (Of course, I should be busy enough not to take time to write this response either, but I feel compelled.) I will agree that the previous user who changed the percentage to 1-5% overlooked the fact that it was a figure referring to very specific group, not the general population. Doczilla _{@SUPERHEROLOGIST} 04:30, 7 February 2019 (UTC)

Subsection of Definitions: Use of Individual Research as Sources Referenced

"Some terms have been proposed regarding dissociation. Psychiatrist Paulette Gillig draws a distinction between an "ego state" (behaviors and experiences possessing permeable boundaries with other such states but united by a common sense of self) and the term "alters" (each of which may have a separate autobiographical memory, independent initiative and a sense of ownership over individual behavior) commonly used in discussions of DID. Ellert Nijenhuis and colleagues suggest a distinction between personalities responsible for day-to-day functioning (associated with blunted physiological responses and reduced emotional reactivity, referred to as the "apparently normal part of the personality" or ANP) and those emerging in survival situations (involving fight-or-flight responses, vivid traumatic memories and strong, painful emotions, the "emotional part of the personality" or EP). "Structural dissociation of the personality" is used by Otto van der Hart and colleagues to distinguish dissociation they attribute to traumatic or pathological causes, which in turn is divided into primary, secondary and tertiary dissociation. According to this hypothesis, primary dissociation involves one ANP and one EP, while secondary dissociation involves one ANP and at least two EPs and tertiary dissociation, which is unique to DID, is described as having at least two ANP and at least two EP. Others have suggested dissociation can be separated into two distinct forms, detachment and compartmentalization, the latter of which, involving a failure to control normally controllable processes or actions, is most evident in DID. Efforts to psychometrically distinguish between normal and pathological dissociation have been made, but they have not been universally accepted."

When reading through the guidelines of psychological and medical Wikipedia articles, it is specified that primary sources should be used as references. References that do include findings of research must summarize research consistency across multiple different studies that have found similar findings. Although these references to these individual researchers in the definitions subsection of this article, I believe that this paragraph should not be included in the article. I would like the opinion of others on this topic before the removal of this paragraph is done. What do you think?

Paigewilson2020 (talk) 18:27, 5 April 2019 (UTC)

ICD-10 Numbering

1. Wrong in article: "F44.8.81"
2. Correct, same source: "F44.81"

Number 1 just isn't how ICD-10 works. --92.195.216.165 (talk) 21:26, 6 April 2019 (UTC)

Thanks and fixed. Doc James (talk · contribs · email) 17:47, 8 April 2019 (UTC)

"Split personality" as sometimes a synonym

This ref says:

"DID commonly called multiple personality or split personality"

This ref says:

"With the onset of the DSM classification system, it has been called split personality. In the latter half of the 20th century it has morphed into multiple personality"

There are a fair number of other refs that say the same. Yes this is an older term for the condition and one used mostly by the lay public. Doc James (talk · contribs · email) 18:41, 5 April 2019 (UTC)

Then find one which is both scientifically credible and actually states it as a medical synonym, not just a common expression, which subsumes layperson's terms. Neither DSM nor ICD accept this, and it is rarely ever used in psychiatric language. --92.195.216.165 (talk) 19:25, 5 April 2019 (UTC)

It was discussed here Talk:Dissociative_identity_disorder#"Split_personality" by User:Flyer22 Reborn. Is a lay synonym NOT a synonym? People rightly or wrongly use the term split personality to mean this condition.

And why are we removing the link to this disamib Split personality (disambiguation)? Doc James (talk · contribs · email) 19:43, 5 April 2019 (UTC)

Please have the courtesy to spare me your rhetorical games of introducing the made-up "layperson's /synonym/" to try and trick me into accepting your point as part of my defence. A layperson's /colloquialism/ is not a synonym. The term you try to defend is /so/ inappropriate, that in the aftermath of the very discussion you reference, it was /not/ re-introduced to the top few sentences of the article. It has no place in the /medical/ info-box. You're free to add it to Wiktionary, or an appropriate section of the article /body/ as a cultural or socio-linguistic aspect. In regards to the disambiguation, is there a particular policy I'm unaware of which mandates redirects with corresponding disambiguation pages to be referenced in the article like this? If so, would there be any further such disamb pages? --92.195.216.165 (talk) 20:05, 5 April 2019 (UTC)

It is standard practice to add links to disambig pages for names that redirect to articles. Doc James (talk · contribs · email) 20:13, 5 April 2019 (UTC)

Your 2nd reference, once again, does /not/ support the idea of a /synonym/, merely of a colloquialism. Just because a determined person with time to spare can Google books in print which state something as a "common" term, doesn't make it a synonym. "Split personality" is equally a colloquialism for schizophrenia, and if you'd Google that instead, voila, here come the references. Just because you find something that looks like a ref, doesn't mean it has the quality required. You will /not/ find a book which states "multiple personality disorder" to be a common name for schizophrenia -- because it's a proper synonym, not a layperson's term. --92.195.216.165 (talk) 20:19, 5 April 2019 (UTC)

A synonym is simple a word or phrase that means nearly the same as another. Split personality is often used to mean the same condition as DID. This is similar to how heart attack is often used to mean myocardial infarction (though it is also sometimes used to mean cardiac arrest) Doc James (talk · contribs · email) 20:34, 5 April 2019 (UTC)

(1) It's not used in medical language, as opposed to heart attack. (2) Terms which are strictly layperson's terms aren't added, which is why "bug" or "snuffles" are missing as synonyms for the common cold. (3) By definition, a synonym must have the same level of ambiguity as the expression it is synonymous with. That is clearly not the case, as "split personality" may refer to schizophrenia, which isn't true for either Dissociative Identity Disorder or Multiple Personality Disorder. --92.195.216.165 (talk) 20:51, 5 April 2019 (UTC)

agree w/ Doc James in terms of Split personality--Ozzie10aaaa (talk) 21:02, 5 April 2019 (UTC)

For example, vehicle can sometimes mean car. However, that doesn't make it a synonym. As in, one of your mistakes is already right in the very oxymoron you chose as this section's title: There is no such thing as a "sometimes synonym." --92.195.216.165 (talk) 21:03, 5 April 2019 (UTC)

I don't agree w/ your opinion--Ozzie10aaaa (talk) 21:28, 5 April 2019 (UTC)

In regards to the "heart attack": "While a cardiac arrest may be caused by heart attack or heart failure, these are not the same," and it has therefore been rejected as a synonym. What you propose simply does not match the definition of synonyms, and your very exampled just proved that mere colloquial use doesn't suffice. --92.195.216.165 (talk) 21:35, 5 April 2019 (UTC)

the page has been protected--Ozzie10aaaa (talk) 21:51, 5 April 2019 (UTC)

Beside the point. Also, you should have waited to see if others want add to this section before performing your strength in numbers act. --92.195.216.165 (talk) 21:56, 5 April 2019 (UTC)

I think the problem is in the infobox. It shouldn't say "synonyms". It should say "Other names". That removes the difficulty about whether it is an exact synonym (which is what 92.195 is demanding), and makes it easier for English language learners to understand as well. WhatamIdoing (talk) 03:31, 6 April 2019 (UTC)

User:WhatamIdoing wonderful suggestion and done. Doc James (talk · contribs · email) 13:55, 6 April 2019 (UTC)

References

Because split personality has also been a term used for schizophrenia, treating it as a fair synonym here is inappropriate and confusing. It has never been the proper term for MPD/DID. The lay synonym argument would suggest that all terms that are used incorrectly to mean other things should be referred to as synonyms. As a matter of fact, a great many people have incorrectly used the word schizophrenia to refer to MPD/DID. Are we going to list schizophrenia here as a synonym, too? Doczilla _{@SUPERHEROLOGIST} 04:40, 6 April 2019 (UTC)

Excellent point. It is not a function of an encyclopedia to confirm persons who have an inaccurate understanding of a subject, in those inaccuracies.

Nihil novi (talk) 05:44, 6 April 2019 (UTC)

On the other hand, one of our goals is to make sure that people know that they've arrived at the page that they were looking for. That means that we probably shouldn't omit it entirely. WhatamIdoing (talk) 06:21, 6 April 2019 (UTC)

Which is our misinformed reader looking for as "split personality"? "Multiple personality disorder"? Schizophrenia? Something else?

Nihil novi (talk) 06:48, 6 April 2019 (UTC)

Split personality is most often used to mean DID just as heart attack is most often used to mean MI. Similarly split personality is much less commonly used to refer to schizophrenia and is a poor name regardless just as heart attack is less often used for cardiac arrest. Doc James (talk · contribs · email) 14:19, 6 April 2019 (UTC)

Non-IPs make the same point. Edit warrioring admin behaves. Miraculous. --92.195.216.165 (talk) 14:33, 6 April 2019 (UTC)

You obviously know how WP works. You can start a RfC if you wish further opinions. Doc James (talk · contribs · email) 14:47, 6 April 2019 (UTC)

Regarding the synonym issue, the current state is tolerable: Adjusted disamb and infobox template. Could have had that 12 hours ago, too. Regarding the way you don't comment changes, discard large edits instead of fixing minor issues yourself or alerting the contributor to do so, hence losing them to article history, and don't engage with IPs in discussion, when you can drown them in shows of edit warring reverts and power, we already know that, but insight comes from within, so just have an honest think about it: If having the best articles is your primary goal, what's your gain from this, really? --92.195.216.165 (talk) 15:09, 6 April 2019 (UTC)

Um, someone who has replied to you repeatedly cannot really be said to not "engage with IPs in discussion". He did not "agree with" you, but he did "engage with" you, despite what seemed to me to be rather unfriendly comments. If someone wants to sit down and have a think, then I might suggest "You'll catch more flies with honey than with vinegar" and How to Win Friends and Influence People as subjects. WhatamIdoing (talk) 15:50, 8 April 2019 (UTC)

Agree that "one of our goals is to make sure that people know that they've arrived at the page that they were looking for." WhatamIdoing's suggested edit clearly works. Flyer22 Reborn (talk) 04:46, 9 April 2019 (UTC)

Broadly accepted recommendations

IMO can simple be stated as fact. Additionally per WP:MEDMOS we use person rather than patient generally. Doc James (talk · contribs · email) 15:29, 27 April 2019 (UTC)

Agreed, as long as it is the current broadly accepted recommendation and it is not in violation of general ethics. This should both be obvious, but especially trauma patients, who are frequently very disempowered, desperate, lacking appropriate defence of their boundaries and healthy volition, are still often victims of abuse through pseudo-therapists. Luckily, those increasingly seem to refrain from publishing it. I am adding pseudo- to signify that a person engaging in such behaviour cannot rightfully be called therapist. An example of a current broadly accepted recommendation is interacting with identities directly as they present, instead of demanding switches or refusing to talk to certain identities (cf Brand 2012). An example of general ethics is respecting the clients wishes, for instance when stating they only care about a good life through communication and cooperation (resolution), where a pseudo-therapist might try to push for identity integrations (fusion), maybe even covertly so. Such violations of boundaries and abuse of power are still common with many pseudo-therapists, especially in regards to DID. However, their clients are not delusional, like in acute psychosis. Hence, any transgression of boundaries is unethical, including forced pseudo-treatments like covert agendas. Surgeons have to respect patients wishes, even if they do not personally agree, and so do therapists. They are free to decline treating a client. They are not free to disregard a client's wishes. --92.195.170.107 (talk) 12:36, 5 August 2019 (UTC)

DSM-V vs. DSM-5

In some parts of the article, the DSM-5 is referenced at DSM-V. The APA reformatted the DSM to a number system with the introduction of DSM-5. 21:23, 8 May 2019 (UTC)

Solved, somebody fixed it. --92.195.170.107 (talk) 12:39, 5 August 2019 (UTC)

IP's removals

Regarding this, this and this, I told the IP, "We are not going to remove the fact that this diagnosis is controversial and why." And when it comes to sourcing and what to include, we follow the literature with WP:Due weight. I suggest the IP read WP:NPOV, which WP:Due weight is a part of.

Note that we have had issues with the FrankEM socks at this article. His socks are related to the material the IP disputes. You can, for example, see him talking with his Tylas sock at Talk:Dissociative identity disorder/Archive 11#Rise and Shine! It's peer review time!. He's used IPs as well. Flyer22 Reborn (talk) 02:08, 15 September 2019 (UTC)

Have protected the article in question. Doc James (talk · contribs · email) 04:21, 16 September 2019 (UTC)

Editing

I recommend that this entry receive a careful edit, not only to correct some grammar issues but also to improve clarity for the general reader. Expertise in subject matter is not, unfortunately, automatically blessed with perfection in communication, particularly when the primary audience consists of people who are not experts. If it were, professional science writers and the editors of journals and textbooks would be out of work! (Said with a wry smile—too many of them have lost out in the past few decades.) Merry medievalist (talk) 21:56, 26 September 2019 (UTC)

Semi-protected edit request on 13 November 2019

I request access to edit this page for the purpose of correcting grammar. I will not be providing examples at the moment, however, I can assure you my corrections will be improving the grammatical structure of this page. Elanalamount (talk) 14:31, 13 November 2019 (UTC)

Not done: Your request is blank or it only consists of a vague request for editing permission. It is not possible for individual users to be granted permission to edit a semi-protected page; however, you can do one of the following:

• If you have an account, you will be able to edit this page four days after account registration if you make at least 10 constructive edits to other pages.
• If you do not have an account, you can create one by clicking the Login/Create account link at the top right corner of the page and following the instructions there. Once your account is created and you meet four day/ten edit requirements you will be able to edit this page.
• You can request unprotection of this page by asking the administrator who protected it. Instructions on how to do this are at WP:UNPROTECT. A page will only be unprotected if you provide a valid rationale that addresses the original reason for protection.
• You can provide a specific request to edit the page in "change X to Y" format on this talk page and an editor who is not blocked from editing will determine if the requested edit is appropriate. —KuyaBriBri^Talk 15:55, 13 November 2019 (UTC)

Not sure where this is being posted. I am trying to get a message to the editors. I believe the information on this page is incorrect. DID is not the same as or previously known as MPD. — Preceding unsigned comment added by 64.119.80.70 (talk) 15:22, 19 December 2019 (UTC)

Semi-protected edit request on 10 November 2019

For disorder causes, “therapy-induced” is listed and has footnote 4 & 5. I read both sources and they do NOT say the disorder is therapy-induced, and to say so is factually incorrect based on current trauma research. 65.128.154.73 (talk) 12:00, 10 November 2019 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. In particular, the section for the "therapy induced" section doesn't contain sources labeled #4 and #5. Sceptre (talk) 01:52, 11 November 2019 (UTC)

SCM is mentioned in #4, Adult Psychopathology and Diagnosis, on page 427. However, SCM is a belief held by a far minority of psychologists. Is there a way in which we can structure the article such that this is reflected? For instance by moving the "Therapist-induced" section from "Causes" to a new "Controversy" section. 173.56.53.239 (talk) 04:50, 19 January 2020 (UTC)

ICD-11 updates

I hope I'm adding this part of the talk page in the right place; I selected 'new section'.

At the end of the 're-classifications' section where it outlines DID's current status in the ICD-10, I added a brief sentence about its place in the upcoming ICD-11. I'm not a regular editor here so I don't know all the protocols so after making the edit I got worried and I thought I should maybe check in on the talk page to make sure this was ok for me to do. It's a weird time where the ICD-11 is essentially complete but not yet in official use, so I'm not sure if there are guidelines about when it should be incorporated into medical articles. My main reasoning is that the ICD-10 information was from 1994, so even though the ICD-11 isn't in official use yet, it reflects a more up-to-date version of the WHO's stance on DID. That section is still under '20th century' which correctly reflects the ICD-10, but not the ICD-11, so I don't know if I should have put this information under '21st century' instead, but it seemed to flow on well from the ICD topic there.

This could also be an opportunity to discuss DDNOS-1 which is now "partial dissociative identity disorder" in the ICD-11. Since it's now considered a distinct disorder and its name overlaps with DID, I expect this article might need to incorporate that at some point. I don't intend to make those kinds of changes because that's a bit beyond my knowledge of Wikipedia editing, but I thought it could be helpful to bring this up to the people who are more involved with maintaining the page.

Thanks!! 101.164.225.123 (talk) 18:30, 16 April 2020 (UTC)

"religious practices, or other mental health problems" ?

(Cough) - Immigrant laborer (talk) 16:11, 19 October 2019 (UTC)

I think that's a cultural reference to trance states. Some religions / belief systems have experiences of possession. It's in the exclusion criteria. Plus can't be diagnosed if another mental health condition can fully account for symptoms. Amousey (they/then pronouns) (talk) 22:51, 5 June 2020 (UTC)

Differential diagnosis and Comorbidities

From DSM-5 full version Differential:
•Other specified dissociative disorder (formerly Dissociative Disorder Not Otherwise Specified) - if criteria A of D.I.D. isn't met
•Major depressive disorder
•Bipolar disorders, bipolar II is a common misdiagnosis
•PTSD
•Psychotic disorders, particularly due to confusion around hearing voices of personality states being mistaken for psychotic hallucinations
•Substance or medication induced - this is an exclusion
•Seizure disorders
•Personality disorders - especially borderline - distinguished by the variation in presentation over time caused by different identities compared to the pervasive and persistent dysfunction of personality dissorders
There's a few others less significant.

Comorbidities: many
•PTSD •depressive disorders, trauma- and stressor-related disorders, personality disorders (especially avoidant and borderline), conversion disorder, somatic symptom disorder, eating disorders, substance-related disorders, OCD, and sleep disorders.
Associated features supporting diagnosis:
Anxiety, self-injury, depression, non-epileptic seizures, flashbacks, flashbacks with amnesia for content of flashbacks, multiple forms of maltreatment as child or adult, multiple forms of non-maltreatment childhood trauma (eg medical, overwhelming early life events), etc. Amousey (they/then pronouns) (talk) 21:44, 5 June 2020 (UTC)

Amousey, honestly, you should just edit the article yourself. I doubt anyone would oppose to it. 14.169.143.236 (talk) 09:35, 8 June 2020 (UTC)

Regarding this? I guess I will go ahead and comment since Doc James is away. Why are you removing the fact that "The cause of DID is unknown and widely debated"? This can be easily supported by WP:MEDRS-compliant sources. We should not present this condition as though its validity is not questioned by professionals. There are other issues with your comments on this talk page, but I'd rather not get into all of that. And as for the above IP, see Talk:Dissociative identity disorder/Archive 12#IP's removals. Flyer22 Frozen (talk) 22:43, 8 June 2020 (UTC)

You have also overtagged; for instance, here. As made clear by WP:MEDDATE, the WP:MEDRS guideline is relaxed when it comes to the History section. The inclusion of primary sources in the History section is usually not much of an issue, if an issue at all. Flyer22 Frozen (talk) 22:50, 8 June 2020 (UTC)

And, yes, I know that the Controversy section exists, but the "Causes" section should also address a bit with regard to the debate. Flyer22 Frozen (talk) 22:57, 8 June 2020 (UTC)

Can you explain on overtagging? Do I just tag each problem source once? If that's the case I will go and sort it. As per WP:MEDRS it says use WP:RS on history, but primary sources are not recommended still.

I removed that part because that view no longer has support in any tiertary sources and wasn't in the source here, some Merck references went back to 2012 or earlier so I don't know what was there before. I checked the DSM-5, DSM-IV (text revision, from 2000) and ICD-11 plus the Merck manual. I think even by 2000 the debate on courses was gone and there's been extra evidence from neuroscience since.

For cause(s) that used to be controversial / uncertain but no longer is then that belongs in history or controversy rather than causes (it's kind of like mentioning bad mothers on the schizophrenia page - a hypothesis disproven many years ago. I also toned down the wording related to causes since it was more restrictive / precise than the sources had. I have yet to find a tiertary source on genetic link but haven't finished reading up. All mental health follows the Biopsychosocial model though. Going by MEDRS we should be using the last 5 years for sources. If you can find something that is a similar standard to the tiertary ones then feel free to add it. As per WP guidelines, it's about achieving consensus, so thank you for your comments. I hadn't realized that sock puppets were on here recently. Amousey (they/then pronouns) (talk) 23:19, 8 June 2020 (UTC)

Amousey, what WP:MEDRS-compliant source do you have stating that the cause of DID being unknown and widely debated is no longer a reality or is simply historical? I also question the argument that the "view no longer has support in any tiertary sources" since tertiary sources aren't as preferred/aren't as strong as secondary sources anyway. It's why WP:SCHOLARSHIP emphasizes secondary sources.

And as has been discussed times before, WP:MEDDATE is not to be used strictly. It doesn't mean that the source needs to be a source from within the time span of the last five years. It means that the material needs to be up-to-date. A source can be from 2012 and still up-to-date with respect to the literature. Editors interpreting WP:MEDDATE strictly is why the guideline was changed away from "Look for reviews published in the last five years or so, preferably in the last two or three years." and the following is currently in its place: "In many topics, a review that was conducted more than five or so years ago will have been superseded by more up-to-date ones [...]." Also, per WP:MEDORG, we shouldn't simply be relying on what the DSM-5, ICD-11, or WHO states. However the DSM-5 treats a condition doesn't take away from how it is treated within the general literature. WP:MEDORG states, "Guidelines by major medical and scientific organizations sometimes clash with one another (for example, the World Health Organization and American Heart Association on salt intake), which should be resolved in accordance with WP:WEIGHT. Guidelines do not always correspond to best evidence, but instead of omitting them, reference the scientific literature and explain how it may differ from the guidelines. Remember to avoid WP:original research by only using the best possible sources, and avoid weasel words and phrases by tying together separate statements with 'however', 'this is not supported by', etc." It also relays, "Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include the U.S. National Academies (including the National Academy of Medicine and the National Academy of Sciences), the British National Health Service, the U.S. National Institutes of Health and Centers for Disease Control and Prevention, and the World Health Organization. The reliability of these sources ranges from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature."

I highly doubt that the DID diagnosis is no longer debated/no longer controversial.

Regarding WP:MEDDATE and history sections, I don't see what else to state. WP:MEDDATE clearly relays, "There are exceptions to these rules of thumb." It lists History sections by stating they "often cite older work." When citing older works, primary sources are often used. Sure, you can use secondary sources, and I'm not discouraging their use. I'm just stating that there is no need to be as strict with history sections when it comes to WP:MEDRS. We typically aren't that strict when it comes to those sections. Similar goes for "Society and culture" sections, where media sources may be included. Flyer22 Frozen (talk) 00:23, 9 June 2020 (UTC)

Thanks for pointing that out about tiertary sources - I thought they were the preferred ones. If it's in the article as "controversial" within psychiatry or cause "unknown" then there should be no problem finding a citation for that. I don't need to prove a negative. Higher up on the page I mentioned the ICD-10 to ICD-11 changes though. The ICD-10 "blue book" (1992) started DID bit with "This disorder is rare, and controversy exists about the extent to which it is iatrogenic or culture'specific.". But the ICD-10 (2017) version (online) and the ICD-11 (2019) version no longer says this. There's no mention of controversy, iatrogenesis or mention of it being rare (The DSM-IV did similar). Review 5422461 here provides evidence on validity (as you mentioned earlier). I think it would be easier to discuss if you could cite your sources. Amousey (they/then pronouns) (talk) —Preceding undated comment added 00:56, 9 June 2020 (UTC)

Given Wikipedia:Identifying reliable sources (medicine)#Respect secondary sources (in addition to WP:PSTS), I'm not sure why you would think that tertiary sources are the preferred ones. We obviously do consider and use tertiary sources, and they can at times be more helpful and/or reliable than secondary sources, but they aren't the preferred sources for Wikipedia. Keeping all of that in mind, I often do look at and cite tertiary sources. Moving on... The "Adult psychopathology and diagnosis" source, from John Wiley & Sons, used in the article is from 2014. That is from only a few years ago, and is written by psychology experts, including Deborah Beidel. The description for the book on Google Books states that it is "Updated to Reflect the DSM-5." It speaks of the controversial nature of DID and the rarity of it. On page 416, it states, "Population prevalence estimates vary widely, from extremely rare (e.g., Piper 1997; Rifkin, Ghisalbert, Dimatou, Jin, & Sethi, 1998) to rates approximating that of schizophrenia (1-2%;Coons, 1998; Ross, 1997). Estimates of DID inpatients settings range from 1-9.6% (Rifkin et al., Ross, Duffy, & Ellason, 2002)." On page 417, it states, "DID is the most controversial dissociative disorder, and easily among the most controversial disorder in DSM-5." It goes on to speak of skeptics and proponents of the disorder. So I do not know why you tagged this as "failing verification" in the lead unless it's because you are looking for the source to state "within psychiatry."

This 2015 "Massachusetts General Hospital Comprehensive Clinical Psychiatry" source, from Elsevier Health Sciences, page 395, states, "Dissociative disorders are among the most controversial, as well as the most intriguing, psychiatric conditions. [...]." It speaks of DID being the most famous of the conditions, and also states that "most clinicians continue to view the concept of dissociation as a rare, albeit possible, response to horrific and traumatic events and experiences. [...] [T]here are a number of dissociative conditions described in the DSM-5 that have undergone re-classifications. [...] [A]s one might expect given the controversies surrounding dissociative identity disorder, this particular syndrome has undergone the most fundamental changes. This chapter defines the overall concept of dissociation, gives brief summaries of the main dissociative conditions, and discuss etiology and treatment." On page 397, the source states, "Among the dissociative disorders, DID has received the most attention over the last two decades and has endured considerable controversy. The positive aspects of this controversy involve an ongoing debate regarding the interplay of society on psychiatric nosology, as well as a careful re-examination of all dissociative phenomena and their relationship to consciousness and pathology. [...] The DSM-5 has added criteria to the diagnosis of DID to include cases of apparent spiritual or demonic possessions, though this aspect of the changed definition remains somewhat controversial'."

Skipping years ahead, the 2020 "A systematic review of the neuroanatomy of dissociative identity disorder" source, from European Journal of Trauma & Dissociation, you cited higher on the talk page states, "Dissociative Identity Disorder (DID) is a complex and controversial diagnosis that has undergone multiple revisions in the Diagnostic and Statistical Manual of Mental Disorders (DSM) since its recognition in the 1950s (North, 2015). There is not a clear understanding of DID etiopathology, there is no standardized method of diagnosis, and as such, the disorder has been plagued by a history of fabrication case studies (North, 2015). For these reasons, the disorder is opposed by many psychiatrists. To address this controversy, researchers have begun to examine the neurological basis of DID in an effort to provide stronger physical evidence for the disorder." And while I know that one should not just cite the abstract, the source beyond its abstract goes over all of what I quoted. I took the time to read it.

Above you stated, "I suggest avoiding book chapters especially undergraduate textbooks since may are out of date with the APA saying many don't cover trauma, abuse or dissociative disorders correctly and in keeping with NPOV avoiding any sources that generated letters of complaint, or primary research." Huh? Conditions that are controversial and rare do not suddenly become non-controversial and non-rare because the latest ICD doesn't mention the controversy or rarity of that condition. If one wants to state that a condition is no longer controversial or rare, then that person does need to provide reliable, academic sources for such a statement. We do not get to make such a claim ourselves or assume that it's the case because we don't have a source within the last five years stating, "No longer controversial or a rarity, people." In this case, though, I have cited academic sources that are within the last five years calling this condition controversial and/or rare. Reliable academic sources usually don't state that it's not rare or that it's common, or even relatively common. And, yes, I know that I cited a source stating "to rates approximating that of schizophrenia", but DID is usually cited as being very rare (as in rarer significantly less common than schizophrenia).

DID seemingly being so rare is why you are not seeing as many new sources on the topic that you are perhaps looking for. I did just look on PubMed. With respect to WP:MEDDATE, it tells us, "'These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or where few reviews are published." The "and may need to be relaxed in areas where little progress is being made or where few reviews" aspect applies to this topic. Regardless of those thinking this condition is valid, it's a fact that many professionals question its authenticity or how to diagnose it. And citing book sources, chapters or otherwise, is fine per the WP:MEDBOOK section of WP:MEDRS. Of, course, per WP:MEDBOOK, there is a hierarchy when it comes to book types. But as long as WP:MEDBOOK is followed appropriately, there is no issue with using book sources.

On a side note: In the future, it would be better if you point to the actual source instead of pointing to the PMC page. Flyer22 Frozen (talk) 20:54, 9 June 2020 (UTC)

just go for it and add those sources to support the controversy. I'm happy with that. DID has had significantly more research done in the last 5-10 years, hence why the page is out of date in parts, although I noticed the legal section has been marked up as needing changes for some years now. With the undergrad books there is a specific issue around coverage of not only DID, but all dissociative disorders, memory relating to trauma, and the frequency of child sexual abuse in particular. It's come up in research before, but since nobody has suggested one I guess it's not so relevant. Going to start a new thread on other points. Amousey (they/then pronouns) (talk) 21:31, 9 June 2020 (UTC)

Pope 1999 survey on the validity of DID

This is primary research and has been refuted so many times that keeping it in means a lot of references. Pretty typical set of responses pointing out very basic error and bias.

• Pope 1999 survey
• First 2000 Dr. First and Dr. Pincus Reply (criticizing Pope's survey of psychiatrists and explaining why DID and dissociative amnesia are staying in the DSM

The article by Dr. Pope et al. contains a serious misconception

about the standards for adding new diagnoses to DSM-IV and about the placement of the disorders in appendix B (“Criteria Sets and Axes Provided for Further Study”). A new diagnosis was added to DSM-IV only after a comprehensive review of the literature (and often data reanalysis and field trials) determined that there was sufficient empirical evidence to justify its inclusion (1). The reason that premenstrual dysphoric disorder and binge eating ... Dissociative disorders that had already been included in earlier versions of DSM (e.g., dissociative amnesia and dissociative identity disorder) were retained in keeping with the conservative approach to DSM-IV, which “opposes the removal of existing categories in the absence of strong evidence recommending either action. The burden of proof generally rests on providing convincing data for either the removal or the addition of categories in preference to keeping the status quo” (1). However, when there are sufficient data indicating a lack of validity, a disorder can be eliminated, as was done with DSM-III-R’s idiosyncratic alcohol intoxication criteria. Most problematic is the assumption that a simple vote should be the basis for the inclusion of a new DSM category. The authors provided no information on the basis for each respondent’s vote nor on the extent to which the psychiatrists were fully informed as to the full array of empirical information available on the conditions about which respondents were queried. Nor did the authors note whether the framing of these questions elicited such questions as the extent of evidence needed, whether existing disorders should be held to the same standard as proposed conditions, and the impact of changes in DSM on education and research efforts. In other words, these kinds of clinical or scientific questions should have been answered only through a systematic, evidence-based process.

• Coons and Chu complain that Pope doesn't even know the Dissociative Disorders, that DID has been a diagnosis since 1968 and in the literature since at least 1790s... The study by Dr. Pope et al. might be characterized as promoting an extremely polarized viewpoint, with examples of bias including the following:...
• Frankel 2000 refuting Pope's survey (again)
• Veldhuizen 2000 pointing put Pope got his numbers wrong

Amousey (they/then pronouns) (talk) 03:25, 11 June 2020 (UTC)

Prevalence/North America section

I think this should just be worked until the prevelance section, it's mostly coming from a single primary source - a 1990s essay by Joel Paris, 3 citations according to Google scholar. It also uses number of cases in professional literature but calls it prevalence - that's not accurate so would need a rewrite. Given that the first psychiatric manual was published in 1952 it's not a great surprise to see hardly any diagnosis before then. (Europe uses the ICD which didn't get a mental disorders section until the late 1970s which again provides some explanation.
Sources refuting the sociocognitive model and Paris's essay - (there's more but at some point out becomes obvious how the evidence all points in the same direction)

• Reinders (neuroscientists) Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States. The findings are at odds with the idea that differences among different types of dissociative identity states in DID can be explained by high fantasy proneness, motivated role-enactment, and suggestion. They indicate that DID does not have a sociocultural (e.g., iatrogenic) origin
• Dissociative part-dependent biopsychosocial reactions to backward masked angry and neutral faces: An fMRI study of dissociative identity disorder
  

Actors were unable to mimic the neural/behavioral reactions of DID patients. - also supports a specific trauma model called The Theory of the Structural Dissociation of the Personality (TSDP)

• Reinders 2014 -Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder: A PET study and neurobiological model - neuroscience in support of the trauma model only and similarities with PTSD patients
• the 3 already cited in my previous talk thread, eg Disinformation (Brand), Growing not Dwindling, The Rise and Persistence of Dissociative Identity Disorder.
• Rhodes and Sar 2006 (already in the page, Sar is Turkish) - multiple chapters on this book which has Epidemiology for many countries
• [Talk:Dissociative_identity_disorder/Archive_12 old talk page disputing Paris]
• Dohary 2014 - Systematic review
• DID treatment guidelines for Adults (large file) 2011

p122-124 Some authors claim that DID is caused by clinicians who believe strongly in DID and who implicitly and/or explicitly influence patients to enact symptoms of DID. According to this "sociocognitive" model,

DID is a socially constructed condition that results from the therapist's cueing (e.g., suggestive questioning regarding the existence of possible alternate personalities), media influences (e.g., film and television portrayals of DID), and broader sociocultural expectations regarding the presumed clinical features of DID. For example, some proponents of the sociocognitive model believe that the release of the book and film Sybil in the 1970s played a substantial role in shaping conceptions of DID in the minds of the general public and psychotherapists. (Lilienfeld & Lynn, 2003, p. 117) - Despite these arguments, there is no actual research that shows that the complex phenomenology of DID can be created, let alone sustained over time, by suggestion, contagion, or hypnosis (D. W. Brown, Frischholz, & Scheflin, 1999; Cleaves, 1996; Loewenstein, 2007). A number of lines of evidence support the trauma model for DID over the sociocognitive model. These include studies that demonstrate DID in children, adolescents, and adults with substantiated maltreatment with evidence that DID symptoms predated any interaction with clinicians (Hornstein & Putnam, 1992; Lewis, Yeager, Swica, Pincus, & Lewis, 1997), studies of psychophysiology and psychobiology as described above, and studies of the discriminant validity of the dissociative disorders using structured interview protocols, among many others. Furthermore, naturalistic studies have shown that DID patients report many symptoms that, based on research data characterizing DID, were previously unknown to the patients, the general culture, and even most clinicians (Dell, 2006b).

• erasing the SCM model from the ICD
• SCM model not in DSM-5
• Sar 2017 (review) - Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective
• Spiegel 2013 (review) -Dissociative Disorders in the DSM-5
• Ross 2009 Errors of Logic and Scholarship Concerning Dissociative Identity Disorder
  

The author reviewed a two-part critique of dissociative identity disorder published in the (Joel Paris's) Canadian Journal of Psychiatry. The two papers contain errors of logic and scholarship. Contrary to the conclusions
in the critique, dissociative identity disorder has established diagnostic reliability and concurrent validity, the trauma histories of affected individuals can be corroborated, and the existing prospective treatment outcome literature demonstrates improvement in individuals receiving psychotherapy for the disorder. The available evidence supports the inclusion of dissociative identity disorder in future editions of the Diagnostic and Statistical Manual of Mental Disorders.

• Sar 2012 The Scientific Status of Childhood Dissociative Identity Disorder: A Review of Published Research
• Dell 2012 The weakness of the sociocognitive model of dissociative identity disorder
• Mulholland 200) [https://www.tandfonline.com/doi/abs/10.1300/J189v03n04_04 Extraversion in an Inpatient Trauma Program Population: Extraversion in an Inpatient Trauma Program Population
• Dell A new model of DID - p10-11 shows that the symptoms found that are not part of common knowledge can uniquely distinguish DID, refuting the sociocognitive model, also compares to schizophrenia and finds people with DID have more Schneider First Rank Symptoms (the old schizophrenia criteria ) than those with schizophrenia, suggesting large scale misdiagnosis (schizophrenia is one of the 3 common misdiagnoses for DID)
• Trauma and Dissociation in China - there weren't any books, films or mention of DID in the Chinese psych manual at the time, but significant numbers of patients were found to have it

Amousey (they/then pronouns) (talk) 03:25, 11 June 2020 (UTC)

The current version of that section is clearly poor. It needs a rewrite or complete removal.

Also, to simply repeat what I stated above: As for the sociocognitive model being the minority view? Even if it's clear via sources that it is, that obviously doesn't mean that this condition is solely or mostly the result of biological causes. Like the Wikipedia article states, "In about 90% of cases, there is a history of abuse in childhood, while other cases are linked to experiences of war, or medical procedures during childhood. Genetic factors are also believed to play a role." That there is no consensus on the cause is another point I'm making. We should report on the sociocognitive model, but I agree that we shouldn't make it look more prominent than it is. We can present criticisms of it. We can also call it the minority viewpoint if reliable academic sources do. Flyer22 Frozen (talk) 21:22, 11 June 2020 (UTC)

DID Treatment

If DID patient knows about he/she is effected with DID. Then according to me he/she can treatment of himself/herself if he/she makes himself/herself strong in mentally, physically, socially areas then he can beat DID. Singhmakkhan0 (talk) 11:03, 12 June 2020 (UTC)

No evidence supports this. Brand's naturalist and longitudinal studies of DID and the DSM5 both give evidence against this. Evidence on Wikipedia must follow the complicated requirements at WP:MEDRS or they will be removed / reverted. A significant amount of evidence says the opposite to you, including the DSM-5 and DID Treatment guidelines, which refer to the many years it takes most patients to be diagnosed and the continuing instability and symptoms they have before treatment. People cannot "beat DID" in such a simplistic way. There is simply too much trauma and difficulty. That does not even work for depression or the other disorders that typically appear with DID. Unfortunately there is no quick and easy self-help. Amousey (they/them pronouns) (talk) 19:01, 12 June 2020 (UTC)

Treatment section update

Hi User:Flyer22 Frozen. I saw your update. It seems to suggest that some experts are using different techniques to the treatment guidelines. I couldn't see that in the source. What was your concern? Amousey (they/them pronouns) (talk) 23:12, 12 June 2020 (UTC)

Replied above. Flyer22 Frozen (talk) 01:31, 13 June 2020 (UTC)

Rare / sources

Update - we may be discussing what's not on the page. "DID is rarely diagnosed in children" is on the page and accurate according to my sources. Amousey (they/then pronouns) (talk) 23:32, 9 June 2020 (UTC) I think I need to see Epidemiology before I could agree about DID being rare - then we could be sure if it's rare than how rare, and it would need to be in a similar standard of secondary sources to those I have - eg practice guidelines, meta-analysis, and systematic reviews. BTW: if you read my posts earlier up you would have seen that I linked to the full sources for almost everything I'm about to post. It's frustrating to hear you replied before reading. I have the ID for pubmed since it confirms there what is classed as a review and links to everything from there. Can you confirm who wrote the book chapter? Specifically, was it SJ Lynn or S Lillifield (who hold minority views as they have said themselves)? I would check but can't get in Google books right now. Epidemiology -

• Kate 2020 p26 is 3.7% for college students, which is expected to be higher then for adults, she notes elsewhere Philippines and US have similar rates, Turkey has less:

---

Prevalence of DA, DDNOS and DID

If the FM is correct, the most common DD should be the one the public has the greatest awareness of as a person needs to be enacting expected, hence familiar, social role related behaviors and symptoms, yet the lesser known and much less socially defined DDNOS was more prevalent (M = 4.5%) than the highly recognizable DID (M= 3.7%). ----

• Brand 2016 - review "MYTH 3: DID IS RARE

Many authors, including those of psychology textbooks, argue that DID is rare.70,97–99 The prevalence rates found in psychiatric inpatients, psychiatric outpatients, the general population, and a specialized inpatient unit for substance dependence suggest otherwise (see Table ​Table1).1). DID is found in approximately 1.1%–1.5% of representative community samples. Specifically, in a representative sample of 658 individuals from New York State, 1.5% met criteria for DID when assessed with SCID-D questions.77 Similarly, a large study of community women in Turkey (n = 628) found 1.1% of the women had DID.78 Studies using rigorous methodology, including consecutive clinical admissions and structured clinical interviews, find DID in 0.4%–6.0% of clinical samples (see Table ​Table1).1). Studies assessing groups with particularly high exposure to trauma or cultural oppression show the highest rates. ..."

• Sar 2017 - review "Studies conducted in various countries led to a consensus about prevalences of DID:3 5% among psychiatric inpatients, 2–3% among outpatients, and 1% in the general population. Prevalences appear heightened among adolescent psychiatric outpatients and in the psychiatric emergency unit.4,5 Studies conducted in various countries led to a consensus about prevalences of DID:3 5% among psychiatric inpatients, 2–3% among outpatients, and 1% in the general population. Prevalences appear heightened among adolescent psychiatric outpatients and in the psychiatric emergency unit.4,5"
• 2011 practice guidelines for adults - (see refs on existing article or just Google quote below) - I note MEDRS treats these are very high quality secondary sources. ---(p4) "The difficulties in diagnosing DID result primarily from lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias. This leads to limited clinical suspicion about dissociative disorders and misconceptions about their clinical presentation. Most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation. Although DID is a relatively common disorder, R. P. Kluft (2009) observed that "only 6% make their DID obvious on an ongoing basis" (p. 600). "... (p117) DID and dissociative disorders are not rare conditions. In studies of the general population, a prevalence rate of DID of 1% to 3% of the population has been described (Johnson, Cohen, Kasen, & Brook, 2006; Murphy, 1994; Ross, 1991; §ar, Akyuz, & Dogan, 2007; Waller & Ross, 1997). Clinical studies in North America, Europe, and Turkey have found that generally between 1% to 5% of patients in general inpatient psychiatric units; in adolescent inpatient units; and in programs that treat substance abuse, eating disorders, and obsessive-compulsive disorder may meet Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. [DSM-IV-TR}; "

Refuting your book chapter shouldn't be needed given the Epidemiology and higher quality sources above. However,

1. Carol North (North 2015) is the only citation in the book chapter for rarity and she's not a specialist in either PTSD / trauma or dissociative disorders.
2. By the chapter only citing North 2015, it turns out that is a primary source with no epidemiology or prevalence rates given. She might never have had any training in diagnosing dissociative disorders and none are in the most common psych assessments - different clinical interviews are needed.
3. North's is a history paper not about the current status - The Classification of Hysteria and Related Disorders: Historical and Phenomenological Considerations - and gives no prevalence figure and does not mention rarity or cite Epidemiology - if I've got the wrong one then I apologize - it was all I found
4. North's opinion is based on a single primary source - and unfortunately she chose one that was so bad it resulted in a bunch of replies refuting it

• pmid 24060040- Commentary: The Rise and Persistence of Dissociative Identity Disorder
• pmid 23538983 - Growing Not Dwindling: International Research on the Worldwide Phenomenon of Dissociative Disorders
• Disinformation About Dissociation: Dr Joel Paris's Notions About Dissociative Identity Disorder pmid 23538984
• Merck Manual also gives a prevalence to confirm not rare
• ICD-10 classed DID as F44.81 under other dissociative disorders F44.8, ICD-11 separates it from other dissociative disorders which gives a hint at increased significance. Links higher up on the page.

I'm sorry for the rather overwhelming amount I'm posting. Because Epidemiology is factual I would appreciate specific prevalences and systemic reviews, meta-analysis or practice guidelines. As per MEDRS the higher quality secondary sources are key. If you still aren't convinced by these sources then please describe what evidence would be sufficient. Amousey (they/then pronouns) (talk) 23:23, 9 June 2020 (UTC)

Why would you think I replied without reading everything you'd previously posted when I clearly stated, "There are other issues with your comments on this talk page, but I'd rather not get into all of that."? I was clearly watching you edit the article and post here, and was clear that "I guess I will go ahead and comment since Doc James is away."

Anyway, I stand by what I stated above. We need to be following what the overall (as in general) literature states and with WP:Due weight. You stated, "Refuting your book chapter shouldn't be needed given the Epidemiology and higher quality sources above." That book chapter is clearly supported by a number of reliable academic sources on this topic, including somewhat by the "A systematic review of the neuroanatomy of dissociative identity disorder" 2020 source. My point was/is that we don't get to decide what is or isn't controversial or rare. Or what is and isn't outdated. And, per WP:Verifiability, "If reliable sources disagree, then maintain a neutral point of view and present what the various sources say, giving each side its due weight." That means, for example, noting that "there is not a clear understanding of DID etiopathology, there is no standardized method of diagnosis, and as such, the disorder has been plagued by a history of fabrication case studies", while also relaying that "The difficulties in diagnosing DID result primarily from lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias. This leads to limited clinical suspicion about dissociative disorders and misconceptions about their clinical presentation. Most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation." But then again, the "Diagnosis" section of the Wikipedia article already uses the 2011 "Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision" source to support the following, "DID is often initially misdiagnosed because clinicians receive little training about dissociative disorders or DID, and often use standard diagnostic interviews that do not include questions about trauma, dissociation or post-traumatic symptoms."

It's because so many psychiatrists and clinicians are skeptical of this diagnosis and/or report it as rare, and this is firmly noted within the literature, that it's WP:Due for us to mention it. And when citing sources that cite North, like the "A systematic review of the neuroanatomy of dissociative identity disorder" 2020 source, we would not be citing North; we would, for instance, be citing that systematic review. WP:MEDRS is clear that "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies." We shouldn't discard or try to override the "A systematic review of the neuroanatomy of dissociative identity disorder" 2020 source, or specifically the parts of it that cite North, because of personally having an issue with North. An editor's personal viewpoint on North is not how we are supposed to go about editing. If it's due to add commentary from a reliable academic source criticizing North, we can add that. And as for guidelines? Again, we should keep what WP:MEDORG states in mind. To repeat, one of the things it states is the following: "Guidelines do not always correspond to best evidence, but instead of omitting them, reference the scientific literature and explain how it may differ from the guidelines." We also have to be careful to not engage in false balance.

As long as we present both sides with due weight, and don't present this condition as though the proponents are definitely correct, things should be fine. Flyer22 Frozen (talk) 20:14, 10 June 2020 (UTC)

Thanks for your response. Although I stated I shouldn't need to refute the book chapter specifically because the Epidemiology I provided already did - and the book chapter didn't cite or reference any Epidemiology - I did actually refute it anyway as I'm sure you saw. My issue with weight is that there are a small number of people who hold a very specific minority view - they accept that it is a minority view - and those sources are given around 50% of the weight of the page (that's how it feels but it may be less - I didn't count.

Dissociation and Dissociative Disorders: Challenging Conventional Wisdom - Lynn is 2012 acknowledges this. Now 8 years later he's claiming that even his SCM model isn't a full explanation and is seeking some middle ground. The minority view is such a small minority that it is not found in tiertary sources, has no epidemiology and no primary research. I think it's fair to say books like the DSM and ICD are a majority consensus given that they are written by committees with lengthy consultations and commentary etc. Those holding a minority view have typically chosen not to put forward any evidence or arguments for what they want to see. If you look at the number of citations for Steven Jay Lynn, Scott Lilienfeld, Harald Merckelbach, Pope, Boysen, etc, they almost always write together. Often in Canadian Journal of Psychiatry edited by Joel Paris who has the same view. The few reviews they have published have unfortunately produced multiple complaints about basic things like excluding the "TOP DD" studies, ignoring the international research, and not having the data. It's hard to give weight to sources that carry so little weight in terms of evidence. If you search the talk page archives for "SCM" you will find others previously raising the issue of lack of evidence for the hypothesis and not getting replies. Meanwhile the research has really improved and the Eur J of Trauma and Dissociation launched in addition to the US J of T & D. Those I'm citing on the page you will also find on the Complex PTSD guidelines and on some PTSD or Schizophrenia spectrum research. Bessel van der Kolk co-wrote the DID treatment guidelines.

If you can let me know what you want to see as evidence, and any particular point on the page you want to refute (feel free to tagvpage or post here).

Also is there a standard for how much of a page covers history vs treatment, diagnosis, legal issues within WP:MED? The history is interesting but there's so much. The legal side might be over-emphasized due to so many fictional serial-killer portrayals. May be worth comparing with the schizophrenia page on that. There's not really much space for diagnosis process, medication or prognosis. Amousey (they/then pronouns) (talk) 00:30, 11 June 2020 (UTC)

I never argued that the sociocognitive model is the majority viewpoint. As is clear by my posts above, I've been focused on the undeniable controversy surrounding this disorder and on the fact that it is reported as/thought of as rare. But on the topic of majority or minority? Unless we have reliable academic sources commenting on what viewpoints are the majority opinion or the minority opinion, we should not relay anything as the majority opinion or the minority opinion. In this case, the matter of the fact is that we have a number of reliable academic sources, including the 2020 systematic review, making it clear that "there is not a clear understanding of DID etiopathology, there is no standardized method of diagnosis, and as such, the disorder has been plagued by a history of fabrication case studies [...] For these reasons, the disorder is opposed by many psychiatrists. To address this controversy, researchers have begun to examine the neurological basis of DID in an effort to provide stronger physical evidence for the disorder." The matter of the fact is that a number of reliable academic sources are clear that diagnosing DID is difficult due to a lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias. The "2011 practice guidelines for adults" source you cited above is clear about that. These sources don't state "a small number of people [believe DID is rare, etc]." The "2011 practice guidelines for adults" source states, "Most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation." The 2020 systematic review states that "the disorder is opposed by many psychiatrists." If physical evidence for the disorder was strong, there wouldn't be all of this skepticism about the condition and sources like the 2020 "A systematic review of the neuroanatomy of dissociative identity disorder" source wouldn't be looking for stronger physical evidence.

As for the sociocognitive model being the minority view? Even if it's clear via sources that it is, that obviously doesn't mean that this condition is solely or mostly the result of biological causes. Like the Wikipedia article states, "In about 90% of cases, there is a history of abuse in childhood, while other cases are linked to experiences of war, or medical procedures during childhood. Genetic factors are also believed to play a role." That there is no consensus on the cause is another point I'm making. And regarding rarity, we should absolutely report that some sources have called DID rare, while others state otherwise. We should absolutely report that "most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation."

Editors' sole focus when editing this article should not be wanting to present dissociative identity disorder as valid and as though it's not very much questioned. Per the literature, it is very much questioned by the psychiatric community and clinicians. So, to repeat, "It's because so many psychiatrists and clinicians are skeptical of this diagnosis and/or report it as rare, and this is firmly noted within the literature, that it's WP:Due for us to mention it." We should report on the sociocognitive model, but I agree that we shouldn't make it look more prominent than it is. We can present criticisms of it. We can also call it the minority viewpoint if reliable academic sources do. And I stand by what I stated regarding not prioritizing the DSM and ICD over the general literature; I cited WP:MEDRS for that argument.

You asked, "Also is there a standard for how much of a page covers history vs treatment, diagnosis, legal issues within WP:MED?" There isn't. Sometimes there is a lot more history than treatment and diagnosis material. And that makes sense in the case of this article, given that, like the 2020 systematic review states, "there is not a clear understanding of DID etiopathology, there is no standardized method of diagnosis." If there is more history material, that's just how it is and we shouldn't chop away at it just to make the sections of equal size or close to equal size. Also, legal material is sometimes a part of history material. Flyer22 Frozen (talk) 21:22, 11 June 2020 (UTC)

thanks for your reply. I have been having tech issues so I apologise for any remaining wrong words / missing letters in this reply. I'm sure there will be some I didn't spot and fix. I'm sorry for misunderstanding your view. When I tagged the page as not having a NPOV it was to due to the overwelming undue weight given to the socioognitive model, which carries so little creditability that major tierary sources no longer mention it. I think it is worth considering either removing or putting only in the history section to avoid undue weight.

My point of view is a not biolgical cause at all - it's the trauma / overwhelming early stress cause mentioned in the DSM-5, MSD manuals and numerous reviews , and in the DID adult treatment guidelines (2011). The Consensus on the cause is that it is childhood trauma - the list you repeated are all traumatic events (the PTSD criteria lists all as a potential cause of post-taumatic stress). The list you gave are all examples of different traumas - history of abuse in childhood, while other cases are linked to experiences of war, or medical procedures during childhood By medical procedures as described in the treatment guidelines they main painful or frightening ones beginning at a young age (also medical trauma is a potential cause of post-taumatic stress disorder as seen in the PTSD criteria)

Blihar's neuronatomy study has major concerns, for a start MEDRS states to use the Conclusions of a systematic review. You are citing from a part of the introduction which does not include any results from the systematic review - the parts not part of the review cannot be considered to be of Systematic review standard - Blihar did not assess instrument validity only neuronatomy. His statements are contradicted by stronger evidence including the DID adult treatment guidelines he doesn't seem to have seen , many systematic reviews and other studies (citing some below). Other major issues with Blihar's study are :

• Blihar's findings seem to contradict his claims in the introduction, in fact what he claims in the introduction may only be there as a justification for why he did the review in the first place.
• All authors are at the same instiution in the West Indies, none have published anything on DID before, several aren't on ORID and this is Bliar's only paper linked to OCID. His researchgate shosws just 4 publications. His review isn't even on pubmed, which is the suggested place to look for them. He's not a DID or disociative disorders researchers, and given that this is a review he may never have actually met or diagnosed anyone with DID. He could be an academic rather than a clinician .
• I misread the name of the journal - can you find the impact factor? The European journal of Trauma and Dissociation does not appear to have one - it's not even on Scopus. The quality of it is unknown and potentially unreliable peer reviews
• Significant factual errors in the introduction are a bad sign:

False: It's caused by psychological factors (not biological - the neurosience is based on functional imaging showing the usage of the brain eg when alter personalities/parts are on charge and reliving truauma compared to when a non-traumatized part of the personality (host) is in charge - eg regional cerebral blood flow, compared to people with other diagnoses, trained actors simulating alters. This shows the differences but also the similarities with brain activity patterns found in PTSD (all peole with PTSD are traumatized - it cannot be diagnosed without a known, specified trauma). Structural images show similarities with those with PTSD in sizes or different areas of the brain that are now known to relate to trauma and fear processing, eg smaller amydala and hippcampus. The varies brain studies include clear evidence of a trauma basis for symptoms and against a sociocogitive basis. Studies includes ones that I have already cited, eg the one about the masked faces triggering trauma responses in people with DID, Schlumpf et al. Let me know if you want names/links .

• Blihar's statement you mentioned has a single source - Carol North (2015) who again hardly publishes anything on DID, and has a single source - Lynn , Lillenfeld et al who didn't do any research before making their hypthesis sound like a fact .
• False; "the disorder has been plagued by a history of fabrication case studies". If you could find 3 such examples I would be seriously impressed, I haven't seen a single one. Syil was never a case study but a popular press book . It was not cited as evidence for the DSM-III but a totally different study was . Repeating shocking claims and unsupprted theories is a technique used by Lynn, Lillenfeld, Pope etc to try and convince people there is evidence when there is not . Lynn's own book chapter cites North 2015 for some thing which North's paper reference back to Steven J Lynn himself.
• False: "there is not a clear understanding of DID etiopathology, " - I've given many sources including those you repeated about the link to childhood trauma being the only factor described . Also many memories have been corroorated including some case series studies of consecutive patients reaching about 85-90% corrooration. Evidence comes from family members and former abusers who confessed during a joint therapy session or in writing, school and social worker records of abuse, medical records of abuse injuries, police reports during childhood from the person who later is diagnosed with DID or from others , and in some cases enough evidence for an abuser to have been jailed when the person was still a child.
• False "there is no standardized method of diagnosis" - also the WP page currently does not say this - I am not entirely sure what he means since hardly any psych disorders insist on a particular diagnostic method. However the DID adult treatment guidelines - which are a highly rated secondary source according to MEDRS - do list which tools are screening tools (used to see if a diagnostic assesment is worthwhile ) and which are diagnostic tools - his intro mixes them up and misses out all the newest ones.

A "gold standard" is not necessary for any psych disorder to be diagnosed - but here's the link showing all the studies that refer to the SCID-D as the gold standard in diagnosing. Because the evidence has shown it's extremely accurate.

See DID treatment guidelines for evidence of specifity etc.

• False: "the disorder is opposed by many psychiatrists." I doubt that the West Indian authors are aware of the rates of acceptance either worldwide or in the US. They did not examine this so that's just their opinion . There's significant evidence against it , including inclusion in ICD AND DSM for decades , which reflects both scientific evidence and Consensus . No propsal was ever sent to remove any of the disociative disorders from either the ICD or DSM. A radical change of DSM criteria was suggested by Paul Dell but that's it.
• Validity of the disorder and the diagnosis has been questioned many times and as a result the assessment tools are extremely well tested , validated worldwide and have far far greater reliability that for most if not all other disorders , even with systematic reviews on this . Blihar cites North's opinion, and it is not based on any study.

• You said "The matter of the fact is that a number of reliable academic sources are clear that diagnosing DID is difficult due to a lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias." - actally the diagnosic process is not difficult - it doesn't say that anywhere - finding a clinician who has enough training or experience to know what clinical interiew to use is the difficult part - same issue affects Complex PTSD (which isn't a separate DSM diagnosis , but is in the ICD).
• What we are writing here is based on scientific consensus, which is not the same as psychiatrist's consensus - they are just one profession in a large mental health system, and the views of psychologists, psychptherapists, counselors, mental health nurses, licensed clinical social workers (who also treat DID) etc is better reflected in tiertary sources. That Consensus is represented by many organizations - the APA, NAMI, MSD manuals, World Health Organization's ICD which just dropped the SCM mention, DSM, so please continue to bear this in mind, as well as the overwhelming high standard of research into DID, it's diagnosis and causes, in comparison to the tiny and dwindling numbers who repeat the SCM hypothesis and continue "challenging conventional wisdom" (as Steven J. Lynn calls his views). I think I will markup more issues in the page and encourage you to do the same so I can see what points you think are weak or unsupported. Amousey (they/them pronouns) (talk) 19:01, 12 June 2020 (UTC)

I don't think it's productive to keep debating you on following the literature with WP:Due weight. WP:MEDRS is clear that we follow the general literature rather than just what an organization (like the WHO), or manual like the DSM-5, or a diagnostic code like the ICD-11 states. This was also made clear years ago at WP:Med: Wikipedia talk:WikiProject Medicine/Archive 36#DSM 5. And yet, with this edit, you tagged the following statement: "Dissociation, the term that underlies the dissociative disorders including DID, lacks a precise, empirical, and generally agreed upon definition." Your rationale? "Dissociation is not a mental illness so this assertion makes no sense, and the chapter cited begins with a definition of dissociative disorders which is what would be needed to research them. Also the statement about no definition is untrue: DSM-IV (1994) Appendix C p766 defines it: 'dissociation: A disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. The disturbance may be sudden or gradual, transient or chronic.' Also it is defined in the DSM-5 appendix, and Dissociative Disorders are defined in the first page of the full version of the DSM-5 " Huh? As is clear by the Dissociation (psychology) article, whether or not dissociation is a mental disorder depends on how it is being defined. There is the non-pathological kind and the pathological kind. And how the DSM defined a condition in 1994 or now does not negate that condition lacking a precise, empirical, and generally agreed upon definition. I can cite a number of disorders or conditions that have a definition in the DSM or ICD-10, but still lack a precise, empirical, and generally agreed upon definition when it comes to the general literature. In those cases, the DSM and ICD-10 (or now ICD-11) definitions are just two definitions among the literature. And if they conflict with the general literature, they are not more authoritative than the general literature on the "in conflict" parts. Please read that archived WP:Med discussion I pointed to in this paragraph.

I never stated that your point is that DID is due to a biological cause. But the non-sociocognitive aspect is partly attributed to a biological cause. You stated, "The Consensus on the cause is that it is childhood trauma." I haven't seen you cite a reliable academic source speaking on the consensus regarding the cause. Yes, childhood trauma is endorsed as a cause or the main cause, but the exact cause is still a matter of research. The causes are considered complex. This 2014 "Dissociative identity disorder: An empirical overview" source states, "DID is aetiologically associated with a complex combination of developmental and cultural factors, including severe childhood relational trauma." To repeat once more, we are not to call something the consensus view without sources explicitly stating that and when sources like the "A systematic review of the neuroanatomy of dissociative identity disorder" 2020 source is clear that "there is not a clear understanding of DID etiopathology, there is no standardized method of diagnosis." So I removed this. The source stating "The consistency between these experts' recommendations, those described in the ISSTD Treatment Guidelines (2011 ), and the interventions documented in the Treatment of Patients with Dissociative Disorders (TOP DD) study (Brand et al., 2009b) suggest that a standard of care for the treatment of DID is emerging." is not the same as stating "There is general agreement on a standard of care emerging." You stated that "the list [I] repeated are all traumatic events (the PTSD criteria lists all as a potential cause of post-taumatic stress). The list you gave are all examples of different traumas - 'history of abuse in childhood, while other cases are linked to experiences of war, or medical procedures during childhood' ". I also mentioned the fact that the article states, "Genetic factors are also believed to play a role." The "A systematic review of the neuroanatomy of dissociative identity disorder" 2020 source is clear that "researchers have begun to examine the neurological basis of DID in an effort to provide stronger physical evidence for the disorder." It's clearly looking at a biological basis for DID. More on the biology aspect below.

You stated, "Blihar's neuronatomy study has major concerns, for a start MEDRS states to use the Conclusions of a systematic review. You are citing from a part of the introduction." What part of WP:MEDRS are you citing? Given how long I have been around and how many times I have cited and adhered to WP:MEDRS, I want to know what part of that guideline you are citing for "MEDRS states to use the Conclusions of a systematic review" in a way that strictly excludes citing the introduction. Like before, you appear to be interpreting WP:MEDRS in ways not supported at that guideline. Where does WP:MEDRS tell us not to cite the introduction part of a review to support material? You stated that the introduction "does not include any results from the systematic review - the parts not part of the review cannot be considered to be of Systematic review standard - Blihar did not assess instrument validity only neuronatomy." Again, where are you getting your views on WP:MEDRS? Actually point to the part of WP:MEDRS that you think supports what you are stating? I ask because what I see at Wikipedia:Identifying reliable sources (medicine)#Biomedical journals is the following: "Research papers that describe original experiments are primary sources. However, they normally contain introductory, background, or review sections that place their research in the context of previous work; these sections may be cited in Wikipedia with care: they are often incomplete and typically less useful or reliable than reviews or other sources, such as textbooks, which are intended to be reasonably comprehensive." That's not the same as what you stated. "As for the review assessing the validity of DID"? The source goes over the history of the condition, what the general literature reports, and it delves into neuroanatomy to offer validity to DID.

You stated, "His statements are contradicted by stronger evidence including the DID adult treatment guidelines he doesn't seem to have seen , many systematic reviews and other studies (citing some below). Other major issues with Blihar's study are: [...] Blihar's findings seem to contradict his claims in the introduction, in fact what he claims in the introduction may only be there as a justification for why he did the review in the first place. [...]." This is all your personal opinion.

You stated, "All authors are at the same instiution in the West Indies, none have published anything on DID before, several aren't on ORID and this is Bliar's only paper linked to OCID. His researchgate shosws just 4 publications. His review isn't even on pubmed, which is the suggested place to look for them. He's not a DID or disociative disorders researchers, and given that this is a review he may never have actually met or diagnosed anyone with DID. He could be an academic rather than a clinician." I am following WP:MEDRS stating that "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies." For arguments on this topic, I am not so much interested in editors' personal feelings on an author or group of authors. That stated, the journal not being well-known is something to consider. But it's not like I was the only one who cited it; you cited it as possible source before I looked at it.

You stated, "False: It's caused by psychological factors (not biological - the neurosience is based on functional imaging showing the usage of the brain eg when alter personalities/parts are on charge and reliving truauma compared to when a non-traumatized part of the personality (host) is in charge - eg regional cerebral blood flow, compared to people with other diagnoses, trained actors simulating alters." The 2017 Sar source you cited above states, "Dissociative identity disorder (DID) is multifactorial in its etiology. Whereas psychosocial etiologies of DID include developmental traumatization and sociocognitive sequelae, biological factors include trauma-generated neurobiological responses. Biologically derived traits and epigenetic mechanisms are also likely to be at play. At this point, no direct examination of genetics has occurred in DID. However, it is likely to exist, given the genetic link to dissociation in general and in relation to childhood adversity in particular." So whether or not one thinks it has a biological basis, it's not like a biological basis has been ruled out.

You stated, "This shows the differences but also the similarities with brain activity patterns found in PTSD (all peole with PTSD are traumatized - it cannot be diagnosed without a known, specified trauma). Structural images show similarities with those with PTSD in sizes or different areas of the brain that are now known to relate to trauma and fear processing, eg smaller amydala and hippcampus. The varies brain studies include clear evidence of a trauma basis for symptoms and against a sociocogitive basis. Studies includes ones that I have already cited, eg the one about the masked faces triggering trauma responses in people with DID, Schlumpf et al. Let me know if you want names/links." So you are citing brain activity patterns/structural images to argue that there is no biological cause? Hmm. Again, the the 2017 Sar source you cited states, "Whereas psychosocial etiologies of DID include developmental traumatization and sociocognitive sequelae, biological factors include trauma-generated neurobiological responses. Biologically derived traits and epigenetic mechanisms are also likely to be at play. At this point, no direct examination of genetics has occurred in DID. However, it is likely to exist, given the genetic link to dissociation in general and in relation to childhood adversity in particular." And what does the "Conclusion and directions for future research" section of the source state? Well, for example, "Understanding the etiology of DID requires integration of trauma exposure, coping, cognitive, neurobiological, systemic, and developmental factors. These include traumatic experiences, family dynamics, child development, and attachment. [...] While the role of the child's biological capacity to dissociate to an extreme level is unclear yet, there is evidence demonstrating the neurobiological impact of developmental stress. The latter converges around an impairment of connectivity in the central nervous system in affected individuals."

An editor's issue with North does not matter in light of the general literature citing North. I noted that we can include criticism of North. But we are not going to ignore the general literature because it so often cites North.

You stated, "False; 'the disorder has been plagued by a history of fabrication case studies'. If you could find 3 such examples I would be seriously impressed, I haven't seen a single one." Per WP:Verifiability, I do not need to search for these cases. All I need to do is relay what the sources state.

You stated, "False: 'there is not a clear understanding of DID etiopathology.' " Sources I have cited on this matter couldn't be clearer on this aspect. I stated this above in this post: Yes, childhood trauma is endorsed as a cause or the main cause, but the exact cause is still a matter of research. The causes are considered complex. In addition to what the 2017 Sar source states, the "A systematic review of the neuroanatomy of dissociative identity disorder" 2020 source states that "there is a lack of understanding regarding the etiopathology of DID. Many researchers and psychiatrists regard DID as the most severe form of a childhood onset Post-Traumatic Stress Disorder (PTSD) because it is virtually impossible to find a DID patient without a history of PTSD (Chalavi, 2013, Ehling et al., 2007, Vermetten et al., 2006, Weniger et al., 2008). Further, DID shares many features of PTSD with the addition of identity disruption in two or more distinct personalities (Chalavi et al., 2015b). There are currently two competing theories regarding the relationship between trauma and dissociation: the trauma-related model and the fantasy-prone model."

You stated, "False 'there is no standardized method of diagnosis' - also the WP page currently does not say this - I am not entirely sure what he means since hardly any psych disorders insist on a particular diagnostic method." He means what sources like the 2017 Sar source means. And the Wikipedia article did state "There is a general lack of consensus in the diagnosis and treatment of DID" until you removed that text.

I'm not addressing the guideline matter again.

You stated. "A 'gold standard' is not necessary for any psych disorder to be diagnosed." We go by what the sources state with due weight. The sources have not spoken of a gold standard.

You stated, "False: 'the disorder is opposed by many psychiatrists." Reiteration: We go by what the sources state with due weight. And, I mean, the "2011 practice guidelines for adults" source you cited states, "The difficulties in diagnosing DID result primarily from lack of education among clinicians about dissociation, dissociative disorders, and the effects of psychological trauma, as well as from clinician bias. This leads to limited clinical suspicion about dissociative disorders and misconceptions about their clinical presentation. Most clinicians have been taught (or assume) that DID is a rare disorder with a florid, dramatic presentation." One could take that to mean that "the disorder is opposed by many psychiatrists" due to bias. And why is the condition, like the "Adult psychopathology and diagnosis" source states, "the most controversial dissociative disorder, and easily among the most controversial disorder in DSM-5"? Sources do not mince words when stating that skeptics in psychiatry have a lot to do with that. You stated, "I doubt that the West Indian authors are aware of the rates of acceptance either worldwide or in the US. They did not examine this so that's just their opinion. There's significant evidence against it, including inclusion in ICD AND DSM for decades , which reflects both scientific evidence and Consensus." That is your opinion. I don't think I need to repeat that what is in the DSM and ICD doesn't always align with the overall literature and that we give significantly more weight to the overall literature. I pointed to an archived discussion with WP:Med editors making that clear.

You stated that "act[u]ally the diagnos[t]ic process is not difficult." That's your opinion. Reliable academic sources state otherwise.

You stated, "What we are writing here is based on scientific consensus." Not unless reliable academic sources state so. You commented that scientific consensus "is not the same as psychiatrist's consensus - they are just one profession in a large mental health system, and the views of psychologists, psychptherapists, counselors, mental health nurses, licensed clinical social workers (who also treat DID) etc is better reflected in tiertary sources." I don't know what to state to this other than to point to what I stated above about the general literature and not necessarily prioritizing the DSM or ICD. Also, DID is firmly within the field of psychiatry and clinical psychology. Yes, those fields should get more weight than those solely in the field of counseling, for example.

"[T]he overwhelming high standard of research into DID"? Given what I know of the DID literature, we have different views on the existence of "high standard of research into DID." Either way, no editor should be presenting this controversial diagnosis as something that has consensus among psychiatrists and clinicians, or even in general, on things it doesn't have consensus on. Researchers can largely support one viewpoint -- meaning significantly more than others -- but still be clear that there is no consensus or definitive consensus on that particular matter.

I do not want to keep typing up these very long replies in response to your very long replies. An editor should not be trying to push a certain narrative. It is not that hard to follow the general literature with WP:Due weight, even when one disagrees with it and wants to prioritize certain sources over it. Flyer22 Frozen (talk) 01:29, 13 June 2020 (UTC)

I also don't want to keep going over the same ground . I took out the part about dissociation for 2 reasons - it was factually untrue at the time to state there was no definition of dissociation when there was, and there certainly is now. And secondly, I could find no mention of that impacting research. "Dissociation" is something that all of us do to some degree - daydreaming and highway hypnosis are examples of "nomative" dissociation. "Pathological" dissociation is the mental illness kind that you cannot just snap out of, and the kind found in dissociative disorders. But either way, the references did not support the text, and there were several very well known references that have evidence of the text being untrue.

I am struggling to understand why you think a few books and sources written by a tiny number of psychiatrists present a general view - they are all elderly academics. I've given links to the psychiatric manuals, general psychiatry articles from health websites and the main mental health organizations. I haven't seen you post anything similar to support your view on the significance of the SCM. Each time I reply is with a lot of evidence because there is a lot of evidence of what the general view is and what the current scientific research says. I don't really see how you can say only the existing (dated) sources on the page represent the general view. Many of them are primary sources and over 20 years old. So where is there to look for a general view? I am struggling to think of anywhere else to look for the medical info.

As regards cause, I think I follow your perspective. Can the wording just say similar to the main sources, "associated with..." or however the sources put it - plus there's already acknowledgement of some of the social effect on that since I was the one who added it - and I added it to the lead.

As regards controversy - I didn't think it was controversial anymore but you showed me evidence otherwise so I put that back in. And reminded you to add the reference after. There's no justification for jumping to assumptions about bad faith or pushing a point of view. I am following MEDRS.

What's in support of the SCM hypothesis is Steven J Lynn's opinion - and people who cite his opinion - things like a review in a journal with no impact factor, and using an introduction rather than a conclusion are significant in weighting evidence when multiple higher quality sources present different evidence. You haven't directly said what your view on the SCM hypothesis weight is, and in what sections, although you have made it clear that you want it to stay on the page.

Can you could provide support that what is on the page is the general view? Sources of equivalent weight that are recent for the medical parts?

I have provided substantial evidence of undue weight to the minority perspective (the SCM hypothesis) which is held by a handful of people. Some of the publications on the page have significant challenges where others have none. If you are sure of their reliability then find better sources.

I am also not the first editor to raise concerns over lack of neutrality, and over specific poor sources. The SCM model is mentioned multiple times on the talk page as lacking evidence, as well as specific sources being challenged - with no responses from other editors until yours this week. There remains no epidemiology at all to show that the SCM hypothesis is possible, and the drop in mentions of it in literature is apparent, including the drop from the ICD-11. In the time since the 1990s a few new trauma-based models have been introduced and new treatments too - so decisions will need to be made on what is significant enough to mention and where.

(When I talk the SCM being the minority view is for sections not including the history or culture, so sections relying on MEDRS - the popular view based on culture is probably still some kind of serial killer thing...).

There's also the fact we should be writing for a general audience based on medical sources - if the general audience thinks DID is another name for schizophrenia, or that you can catch it from watching too many movies, that it's a personality disorder, or that people recover in X number of weeks or whatever else then those popular beliefs should not be given weight if the medical information does not support it. Wikipedia is an encyclopedia rather than a summary of generally held views. Sometimes the medical evidence is consistent with most people's beliefs, for other things it isn't.

When a view is not even mentioned in key sources like the DSM then you can hardly argue on equal weight.

I am concerned about where to go from here. I am not sure if you are willing to work on replacing the primary sources for parts not supported by other sources or not. I think when the sourcing is improved, the way forward will be clearer. I think the legal section will probably be easiest to agree on. So that is my suggestion.

Alternatively if you want to take some extra time to look for systematic reviews and meta-analysis while I work in some secondary sources, that would be an option. Amousey (they/them pronouns) (talk) 02:45, 14 June 2020 (UTC)

Amousey, no need to ping me. I ask that you do not ping me to this talk page since I am obviously watching it. I'm not pinging you because it is not necessary.

To me, and I'm not trying to offend you since we can all at times fall prey to our personal viewpoints when editing Wikipedia, you are at times going on your personal opinions about this topic. Here's why I feel this way: First, you asserted that tertiary sources are preferred, which is demonstrably false by looking at our sourcing policies and guidelines. Then you challenged the fact that this diagnosis is extremely controversial, when sources that report on/review this topic usually note that it is extremely controversial. You challenged the rarity aspect. Okay. But the fact is that sources, including ones you listed, note that most clinicians believe that this disorder is rare. That is why we should report on those beliefs and then relay what the actual data indicates. More than once you have cited WP:MEDRS in ways that do not support what you are stating. You've spoken on guidelines in sources, but I've noted that the MEDORG section of WP:MEDRS states: "Guidelines do not always correspond to best evidence, but instead of omitting them, reference the scientific literature and explain how it may differ from the guidelines." You stated that you "took out the part about dissociation for 2 reasons - it was factually untrue at the time to state there was no definition of dissociation when there was, and there certainly is now." The text, supported by this 2011 "Adult Psychopathology and Diagnosis" source, states, "Dissociation, the term that underlies the dissociative disorders including DID, lacks a precise, empirical, and generally agreed upon definition." That is not the same thing as stating that there is no definition." And I'm not going to repeat what I stated about definitions above. Unless you have a reliable academic source stating the opposite -- that dissociation, the term that underlies the dissociative disorders including DID, has a precise, empirical, and generally agreed upon definition", that statement should remain in the article.

You stated, "And secondly, [you] could find no mention of that impacting research. 'Dissociation' is something that all of us do to some degree - daydreaming and highway hypnosis are examples of 'nomative' dissociation. 'Pathological' dissociation is the mental illness kind that you cannot just snap out of, and the kind found in dissociative disorders. But either way, the references did not support the text, and there were several very well known references that have evidence of the text being untrue." Huh? You've repeated what I stated about non-pathological and pathological dissociation. And as for "the references did not support the text"? You must be talking about references in the Dissociation (psychology) article. Because this 2011 "Adult Psychopathology and Diagnosis" source supports the "Dissociation, the term that underlies the dissociative disorders including DID, lacks a precise, empirical, and generally agreed upon definition." statement.

You stated that "[you are] struggling to understand why [I] think a few books and sources written by a tiny number of psychiatrists present a general view - they are all elderly academics." Eh? The books I've pointed to, and there are more than just a few books discussing the topic (although, yes, most are older than the ones I pointed to), are reporting on the general literature. And they are reporting on the same thing mentioned in the overview articles or few review articles on this topic. You speak of "a tiny number of psychiatrists", but it's the psychiatrists who are experts on this topic. And besides that, there is the fact that, like the article notes via this 2011 "Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision" source, "clinicians receive little training about dissociative disorders." There are hardly any experts on this topic, meaning those specifically trained to diagnose and treat this condition. More generally, there are psychiatrists, psychologists and clinicians that have studied this topic via some related or overlapping field. Having studied it (like I did years back) is not the same thing as being specifically trained for it. So it's barely productive to state that Blihar "is not a DID or dissociative disorders researcher", like you have done.

You stated that "[you have] given links to the psychiatric manuals, general psychiatry articles from health websites and the main mental health organizations." You have, and have used these sources to assert things not explicitly stated by the sources, to try to challenge sources you apparently disagree with, or to express your personal viewpoints. You've provided sources that contradict your arguments. For example, although you stated, "It's caused by psychological factors (not biological - the neurosience is based on functional imaging showing the usage of the brain eg when alter personalities/parts are on charge and reliving truauma compared to when a non-traumatized part of the personality (host) is in charge - eg regional cerebral blood flow, compared to people with other diagnoses, trained actors simulating alters.", the 2017 Sar source you cited states, "'Dissociative identity disorder (DID) is multifactorial in its etiology. Whereas psychosocial etiologies of DID include developmental traumatization and sociocognitive sequelae, biological factors include trauma-generated neurobiological responses. Biologically derived traits and epigenetic mechanisms are also likely to be at play. At this point, no direct examination of genetics has occurred in DID. However, it is likely to exist, given the genetic link to dissociation in general and in relation to childhood adversity in particular." In other words, there are discussed biological aspects that are considered to be contributing factors.

You stated that you "haven't seen [me] post anything similar to support [my] view on the significance of the SCM." Nowhere was I arguing for the significance "of the SCM." I told you, "I never argued that the sociocognitive model is the majority viewpoint." But I did also tell you, "On the topic of majority or minority? Unless we have reliable academic sources commenting on what viewpoints are the majority opinion or the minority opinion, we should not relay anything as the majority opinion or the minority opinion." I do not want an editor's personal opinion on what they think is the majority viewpoint. And as for SCM? I've noted WP:Due weight. If it should be trimmed and/or given context via competing viewpoints, we can do that. The 2019 "A systematic review of the neuroanatomy of dissociative identity disorder" source states, "There are currently two competing theories regarding the relationship between trauma and dissociation: the trauma-related model and the fantasy-prone mode." Using WP:In-text attribution is also important.

You stated, "Each time [you] reply is with a lot of evidence because there is a lot of evidence of what the general view is and what the current scientific research says." I repeat, "You have used these sources to assert things not explicitly stated by the sources, to try to challenge sources you apparently disagree with, or to express your personal viewpoints. You've provided sources that contradict your arguments." You repeat yourself. You also at times don't seem to truly be considering what I'm stating, which results in me repeating myself. For example, I'm not sure how many times I have to cite what WP:MEDRS actually states about something.

You stated that "[you] don't really see how [I] can say only the existing (dated) sources on the page represent the general view. Many of them are primary sources and over 20 years old. So where is there to look for a general view? [You are] struggling to think of anywhere else to look for the medical info." We've been over this as well. I told you that WP:MEDDATE tells us, "These instructions are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or where few reviews are published." The DID field is not an area that is very active. At all. Also, it is not like I have been pointing you to sources that are 20 years old. I've been pointing you to sources that are only a few years old (or, in the case of the 2019 "A systematic review of the neuroanatomy of dissociative identity disorder", only a year old) and report on/summarize the literature. A few recent reviews that question or challenge the general literature don't mean that we just discount or discard things that have been consistently reported on in the literature. Again, even these recent overviews or reviews acknowledge those aspects. For where they challenge the general literature? This is why I noted that WP:Verifiability tells us, "If reliable sources disagree, then maintain a neutral point of view and present what the various sources say, giving each side its due weight." A source telling us that everything we know about the dissociation debates is wrong has a place, but it doesn't trump the general literature.

You stated, "As regards controversy - [You] didn't think it was controversial anymore but [I] showed [you] evidence otherwise so [you] put that back in. And reminded [me] to add the reference after. There's no justification for jumping to assumptions about bad faith or pushing a point of view. [You are] following MEDRS." You are the one who added tags with regard to the controversy. So when it comes to removing them, you could have also removed them. You did remove this, but you left in the tag for it in the lead. It's not like the controversy fact was not sourced. And that "Adult Psychopathology and Diagnosis" 2014 source (with Deborah Beidel as an author) is absolutely not a poor source for this topic. Something else that was wrong with that tag you added? It's where you stated, "Heading off about society and culture." No, it's not off. It's aligns with WP:MEDSECTIONS. Media material goes under the "Society and culture" heading. I will also note that I'm not obligated to source things an editor is tagging, especially when they are unnecessarily tagging things. As for bad faith and WP:MEDRS? I did not state that you are editing in bad faith. But do I think that you are editing more so from a personal viewpoint? Yes, like I stated above. And we clearly disagree about how you have applied WP:MEDRS.

You stated, "Using an introduction rather than a conclusion are significant in weighting evidence when multiple higher quality sources present different evidence." Again, WP:MEDRS doesn't subscribe to your viewpoint about citing introduction material in a review. If that introduction material is informing us of the general literature, we can absolutely cite that part of the source to relay the general literature.

You stated, "[I] haven't directly said what [my] view on the SCM hypothesis weight is, and in what sections, although [I] have made it clear that [I] want it to stay on the page." Okay, so you are somewhat hearing me. Did I make it clear that I want the SCM hypothesis to stay on this page? No. But in this post, I just sated, "And as or SCM? I've noted WP:Due weight. If it should be trimmed and/or given context via competing viewpoints, we can do that. The 2019 'A systematic review of the neuroanatomy of dissociative identity disorder' source states, 'There are currently two competing theories regarding the relationship between trauma and dissociation: the trauma-related model and the fantasy-prone mode.' Using WP:In-text attribution is also important."

You asked, "Can [I] provide support that what is on the page is the general view? Sources of equivalent weight that are recent for the medical parts?" I didn't claim that everything in the article is the general view. Either way, we have secondary and tertiary sources giving an overview or review of the literature. That is the general literature. Introductions give us an overview of the general literature. When a source gets into its own perspective? That is not the general literature.

You stated that "[you] have provided substantial evidence of undue weight to the minority perspective (the SCM hypothesis) which is held by a handful of people. Some of the publications on the page have significant challenges where others have none. If you are sure of their reliability then find better sources." You have yet to provide a source stating that the SCM hypothesis is the minority perspective or that it is "held by a handful of people." If you have, I missed it. And even if one states that it's clear that it is the the minority perspective, that does not mean it shouldn't be in the article at all. What it would mean is that we should not give it as much weight as the majority perspective. When we see sources not covering a matter as much as another matter, then we don't give it as much weight. We trim, for example. If it is WP:Fringe, we may or may not include it or exclude it altogether. See what WP:Fringe states. It's about what sources states on the topic or if that aspect is barely in the literature.

You stated that "[you are] also not the first editor to raise concerns over lack of neutrality, and over specific poor sources." And a number of those editors were the same WP:Sock editor or editors otherwise pushing a POV.

You stated, There's also the fact we should be writing for a 'general audience' based on 'medical sources' - if the general audience thinks DID is another name for schizophrenia, or that you can catch it from watching too many movies, that it's a personality disorder, or that people recover in X number of weeks or whatever else then those popular beliefs should not be given weight if the medical information does not support it. Wikipedia is an encyclopedia rather than a summary of generally held views. Sometimes the medical evidence is consistent with most people's beliefs, for other things it isn't." No. It's because we write for the general audience that we also include material on misconceptions. It is up to us to make misconceptions clear if reliable sources do. If we did not include material on popular or misguided beliefs, or other societal issues, there would be no "Society and culture" section in our medical articles.

You stated, "When a view is not even mentioned in key sources like the DSM then you can hardly argue on equal weight." That is a personal opinion that is not supported by WP:MEDRS and is, in fact, contrary to WP:MEDRS telling us that statements and information from reputable major medical and scientific bodies are generally less authoritative than the underlying medical literature. If the DSM or ICD necessarily or always represented the underlying medical literature, the aforementioned DSM-5 discussion at WP:Med would not have taken place.

You stated that you are "concerned about where to go from here." So am I. But I do know that I do not want to keep typing up these very long replies in response to your long or very long replies. It takes up a lot of my time. You added that "[you are] not sure if [I am] willing to work on replacing the primary sources for parts not supported by other sources or not." I guess I'll state this again, "I'm not obligated to source things an editor is tagging, especially when they are unnecessarily tagging things." But I did just make this edit. And, yes, I guess I will source other things if you don't source the things you tagged.

You stated that "[you] think the legal section will probably be easiest to agree on. So that is [your] suggestion." Maybe so. Maybe we should focus on that first. Let's give it a try. Doing that will also surely cut back on these very long replies. Flyer22 Frozen (talk) 23:10, 14 June 2020 (UTC)

That sounds good to me on the legal section. There's a number of books on forensic psychiatry that may end up being the main sources. I have been having problems with my vision so I haven't yet been able to read your full reply. From what I have read so far it's clear that I did misunderstand you on some points. So thanks for taking the time explaining.

I noticed you removed the multiple issues tag even though I think significant issues remain - but as I haven't been able to read all you said things I'm sure things will get clearer when I do. I am glad we have a way forward on what can be worked on. I do actually appreciate being tagged at the moment since I have been having issues with notifications. I will try and remember not to ping you back. I had a quick scan of the MED MOS and was hoping you could check over the section order. There are a few particular sources in particular that I think would be better replaced - will start separate thread another time on that. Amousey (they/them pronouns) (talk) 01:24, 15 June 2020 (UTC)

Amousey, thank you. Coincidentally (and as recently mentioned elsewhere on Wikipedia before), I have been having cognitive issues because of a health matter I am dealing with. Beyond that, I can sometimes unintentionally come across as rude when commenting. And when explaining matters, I can come across as condescending. I want to let you know that I don't mean to be rude to you. And anything that seems like condescension is better explained away as me informing you of things that you don't seem to be aware of or maybe do not fully grasp. It seems that you weren't that familiar with the literature before coming to this article? As noted before, I studied the literature years ago (because it sort of overlapped with something else). So I did have to look at the latest sources on the matter.

Regarding tags I removed? It's because I didn't see that the tags in the lead still needed to be there, and because I removed some unsourced and weakly sourced material or replaced it with sourced material. I also wasn't sure why you tagged this book as "primary source|reason=unedited book|date=June 2008." Wait, you didn't tag that, right? Other stuff you tagged is still tagged.

As for WP:MEDSECTIONS? The guideline is clear that we do not have to place things in a strict order. We should design the article in a way that is best for the article. But something like the "Society and culture" section obviously shouldn't come ahead of the more medical material. And I do prefer to be consistent with other medical articles when there is no good reason to depart from the typical setup. The current order seems fine; Doc kept that maintained. Flyer22 Frozen (talk) 01:53, 15 June 2020 (UTC)

I have finally finished reading your response. I want to let you know that you haven't been rude in the slightest, or condescending. And I really do appreciate that. I am sorry if I have come across rudely to you. It seems clear that there is some miscommunication and I suspect some of it is coming from me skim reading sources. My short term memory is not so great, although my long term memory is good.

One particular point I want to pick up is about the sentence on the definition of dissociation - the second part of the sentence linked to the definition directly to an impact on research. That was nowhere in the Kihlstrom reference, and when I checked the book chapter preview I couldn't verify it either - perhaps you can but it went over the page and wasn't part of the book preview I found, so I couldn't see if it was there, and if it was whether it had a source or was an unsourced opinion. However - looking at the fact the sentence was at the start of the Treatment section, it didn't seem a relevant place. Perhaps it should be moved.

I clearly somehow majorly misunderstood part of the MEDRS when I read it and then suggested tiertary sources. I appreciate you taking the time to explain the details. It's clear that you know the policy well.

The particular things that you asked for references for, I think would be best done when editing those sections. I'll make a note of what to come back to. I did wonder if a different understanding of what percentage prevalence the word "rare" suggested was a factor.

With the reliability of sources, I have been debating whether to address the sources individually, by which I mean the ones that are extremely problematic and resulted in letters of complaint and occasionally even criticism of the journal's peer review process. The same well-regarded journals that published the original review or research have in occasion published responses accusing specific authors of "disinformation" rather than genuine scientific criticism. I find that extraordinary and would prefer to find alternatives to those sources at the point at which we are discussing the surrounding article.

I think in the spirit of openness it's worth me pointing out that two particular journals have taken very clear positions on DID very early on, the official journal of the International Society for the Study of Trauma and Dissociation publishes the Journal of Trauma and Dissociation, which is the direct replacement for the journal Dissociation which they also published. And the Canadian Journal of Psychiatry, which is edited by Joel Paris, who is a firmly biologically oriented researcher for the most part, and also an adherent to the SCM. Going back to MEDRS,

Ideal sources for biomedical material include literature reviews or systematic reviews in reliable, third-party, published secondary sources (such as reputable medical journals), recognised standard textbooks by experts in a field, or medical guidelines and position statements from national or international expert bodies. So simply the fact that a review is published by a reputable journal or textbook does not mean it is automatically reliable, and any criticism should be taken into account. I also want to point out: Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early lab results which don't hold in later clinical trials.

While clinical trials are not really relevant, unsourced or minority views are more likely in primary sources. If a point is made in a primary source without a secondary source supporting it then I think we should consider whether to keep that in or not - but we can look at that in a case by case basis.

Rather than respond to all you raised, I think it best to focus on one thing for now and then on the legal section. I think given the misreading and miscommunication I would prefer to try some collaborative editing on the talk page. Amousey (they/them pronouns) (talk) 23:28, 15 June 2020 (UTC)

You stated, "One particular point I want to pick up is about the sentence on the definition of dissociation - the second part of the sentence linked to the definition directly to an impact on research. That was nowhere in the Kihlstrom reference, and when I checked the book chapter preview I couldn't verify it either - perhaps you can but it went over the page and wasn't part of the book preview I found, so I couldn't see if it was there, and if it was whether it had a source or was an unsourced opinion. However - looking at the fact the sentence was at the start of the Treatment section, it didn't seem a relevant place. Perhaps it should be moved." I'm not sure what you mean. The beginning of the Definitions section states, "Dissociation, the term that underlies the dissociative disorders including DID, lacks a precise, empirical, and generally agreed upon definition." I commented on that in my "23:10, 14 June 2020 (UTC)" post above. The beginning of the Treatment section used to state, "There is a general lack of consensus in the diagnosis and treatment of DID[10] and research on treatment effectiveness focuses mainly on clinical approaches described in case studies." It no longer does.

You stated that you "clearly somehow majorly misunderstood part of the MEDRS when [you] read it and then suggested tiertary sources. [You] appreciate [me] taking the time to explain the details. It's clear that [I] know the policy well." I appreciate this. We should also keep in mind that while WP:MEDRS is widely adhered to guideline, it is a guideline rather than a policy.

You stated, "With the reliability of sources, I have been debating whether to address the sources individually, by which I mean the ones that are extremely problematic and resulted in letters of complaint and occasionally even criticism of the journal's peer review process. The same well-regarded journals that published the original review or research have in occasion published responses accusing specific authors of 'disinformation' rather than genuine scientific criticism. I find that extraordinary and would prefer to find alternatives to those sources at the point at which we are discussing the surrounding article." Criticism of sources by other sources is fine when WP:Due. But that doesn't automatically mean that those sources shouldn't be used. I noted before that the DID field is not a very active field. It's not like we have a lot of rich DID literature. We should use the WP:MEDRS-compliant sources that exist, report on the general literature via overviews and reviews, and include any criticisms that are WP:Due (including criticisms of certain sources/authors).

You stated, "So simply the fact that a review is published by a reputable journal or textbook does not mean it is automatically reliable, and any criticism should be taken into account." The second sentence of WP:MEDRS states "all biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge." At Wikipedia, we base the term reliable on what is seen at Wikipedia:Reliable sources#Overview. Now, of course, WP:MEDRS goes further to outline what is reliable in terms of WP:MEDRS. So it states the following: "Ideal sources for biomedical information include: review articles (especially systematic reviews) published in reputable medical journals; academic and professional books written by experts in the relevant fields and from respected publishers; and guidelines or position statements from national or international expert bodies." The word reliable is not in that sentence because, on Wikipedia, those sources are automatically considered reliable for medical information. But as also made clear by WP:MEDRS, they need to be used appropriately and we should still be clear about what general literature reports/how that general literature is. Like I've stated, it is the overview and review articles that detail that general literature to us (for example, that the DID diagnosis is very controversial).

You stated you "also want to point out: 'Primary sources should generally not be used for medical content – as such sources often include unreliable or preliminary information, for example early lab results which don't hold in later clinical trials.' While clinical trials are not really relevant, unsourced or minority views are more likely in primary sources. If a point is made in a primary source without a secondary source supporting it then I think we should consider whether to keep that in or not - but we can look at that in a case by case basis." I agree that "If a point is made in a primary source without a secondary source supporting it then I think we should consider whether to keep that in or not - but we can look at that in a case by case basis." That's the appropriate way to apply to WP:MEDRS. Flyer22 Frozen (talk) 21:44, 16 June 2020 (UTC)

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References

Legal section

I had a quick look at what it currently covers in comparison to Schizophrenia, which is commonly used for the insanity defense, and Antisocial personality disorder (ASPD) - which I believe is the only diagnosis which is considered significantly related to committing crime (crimminal acts is in the optional diagnostic criteria). There's no mention of law or crime on the ASPD page, and what's on the Schizophrenia page is much shorter and less detailed. I think it would be good to reduce the amount of text / detail, and to mention the role of stigma/assumptions of people with DID becoming violent as is covered in the Schizophrenia page. To try and cover the main legal issues in most English speaking countries would be a page in itself. At the moment it cites heavily from Reinders who is a neuroscientist, and from Farrell. I am not really sure of the accuracy of the 3 main points - and if that is up to date or which country it is for - I'm unsure of Reinders' nationality but she's definitively not working/living in the US. I can't find the full text to see if she's specific on which countries. Looking back at archived talk pages there was a mention that Farrell (used twice on the page) might not be a lawyer too. I know there has been a great deal of research on which psych assessments are reliable in DID and which are not, and which can determine malingering, the unusual symptoms in DID can come up as exaggerating/pretending on some scales not intended for DID but not on others. Brand has done most of the research on this. Most books don't cover this. I will look for a source tomorrow but think it worth mentioning. Insanity defense very rarely applies with DID since there is no detachment from reality - whichever personality state is in charge is aware of their actions. Billy Milligan (mentioned on the page) ended committing some minor crimes after being released as integrated into one. Sources of interest:

• Crego 2000 seems as good summary as regards US situation at although it's older than I would like
• Frankel 2007 review
• some old reviews 1
• 2 recent chapters in a book by US authors:
  

1. True Drama or True Trauma? Forensic Assessment and the Challenge of Detecting Malingering - Lorna S Brown - In a book from 2010
2. Dissociation and Dissociative Disorders: Clinical and Forensic Assessment - A Steven Frankel p571-584 - same book

• A UK forensic book on DID - Forensic Aspects of Dissociative Identity Disorder -covers things like the Frye standard used in the US
• Brand 2017, Bouquet 2017 not a review but useful
• Woman to use multiple personalities to testify against father - Recently in the news, an Australian woman with DID was able to testify against her father with different alters taking the stand for different parts of the trial. The case received international coverage.

Amousey (they/them pronouns) (talk) 03:11, 16 June 2020 (UTC)

I'm fine with some of the material being trimmed as long as we adequately summarize the important points. Maybe creating a draft in your sandbox -- a separate sandbox from your main one (meaning a sandbox just for this article) -- so that we can work out the details before implementing changes is the way to go. Flyer22 Frozen (talk) 21:44, 16 June 2020 (UTC)

I'm still working on this, but have some reading up to do on Hein legal sources. It seems like it's going to be better to cover the society / culture and legal section together - because some of the movies are from actual cases or are relevant. Like malingering is highly relevant but also there's a very popular movie/book on just that (Primal Fear) which I think was praised for its realistic portrayal of DID (even though the character turns out to be malingering). Billy Milligan's case I think was the first successful insanity plea and resulted in a book. In looking through I noticed there's no books mentioned apart from those that ended up as movies (Sybil and Eve) but several have been New York Times no 1 bestsellers. Are you happy to have books included also? I think there might be some wider things on culture, including one artist in particular but everything except movies seems split between many unrelated sources. in Popular Culture This from JSTOR (1999) covers a lot of ground, although unfortunately seems to get mixed up between fictional and actual cases. Frankel 2006 is a review (Full pdf online) for the legal side. I have seen little for the legal side in Canada, European countries (except for the UK) or NZ. Amousey (they/them pronouns) (talk) 22:53, 23 June 2020 (UTC)

Well, the "Legal issues" section currently in the article is a subsection of the "Society and culture" section. So I'm not sure what you mean by "It seems like it's going to be better to cover the society / culture and legal section together". Are you saying that certain films are better covered in the legal issues subsection rather than above it (meaning rather than in the general area of the "Society and culture" section)? On a side note: Wikipedia:Manual of Style/Trivia sections#"In popular culture" and "Cultural references" material and Wikipedia:"In popular culture" content provide guidance on covering popular culture content.

We obviously shouldn't cover every book written (fiction or non-fiction) about the topic or every cultural reference. But, yes, including books are fine if WP:Due. And, for some books, they can go in the "Further reading" section.

User:Amousey/sandbox/DID is coming along nicely. Flyer22 Frozen (talk) 00:07, 24 June 2020 (UTC)

Thanks for the encouragement. I wasn't sure if you had seen it yet. If you want to edit that page then go ahead. I was struggling with some of the wording in the last few edits. Amousey (they/them pronouns) (talk) 00:30, 26 June 2020 (UTC)

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References

Popular culture

I just updated the legal section. Reinders was the reference for the previous section about Milligan and lack of success for the insanity plea, and the comment on the Billy Milligan case - I just need a legal reference on Milligan but found the rest. It took some time to find the full text for Reinders, but there was nothing in there about reasons why the insanity plea normally failed so I left that out. The previous text on Milligan sounds accurate to me - but I would prefer a legal source rather than a news one.

I am hoping to update the start of the culture section soon if you can check it out. I haven't put in anything about artists since I only saw it mentioned in one source. I would especially like to replace the Jekyll and Hyde image with something more modern. I will have a look what's available, but a small image of a more recent movie poster/DVD could be used under fair usage, or a picture of either someone who wrote their story, or an actor. I do have a copy of a book I could take a photo of but I think that doesn't count as original enough so would still be under fair usage license. I wanted to check your thoughts on this. I haven't got round to checking what images are on the movie pages I linked to. Amousey (they/them pronouns) (talk) 02:47, 3 July 2020 (UTC)

I'll get back to this later. Flyer22 Frozen (talk) 04:20, 3 July 2020 (UTC)

Happy 4th July if you are celebrating.

I just remembered the United States of Tara series and the main picture there os a good quality and colour one. Toni Collette won an Emmy for playing Tara and her personality states, and it's a notable enough series for it's own WP page. Amousey (they/them pronouns) (talk) 23:56, 4 July 2020 (UTC)

I found a source for Milligan in Farrell so no need to worry about that. Amousey (they/them pronouns) (talk) 01:14, 5 July 2020 (UTC)

The legal material you added looks fine.

I'm sure that your popular culture edits will be fine.

Happy belated 4th to you. I was with some of my family, and making sure that my niece and nephew enjoyed this 4th was the focus. Flyer22 Frozen (talk) 05:10, 5 July 2020 (UTC)

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References

Society and culture section

I'm getting to the end of this (see sandbox page) but have some questions. - I added the United States of Tara poster at the top but a bot keeps removing it. Do you have any views on using this or going with no image? Other good quality images are the movie poster for Frankie and Alice, or images of real people who wrote their own stories or the actors who played them in the films eg Truddi Chase, Chris Costner Sizemore, Halle Berry from Frankie and Alice). Several small pictures would be an option. - I haven't referred to Jekyll and Hyde since mostly it's a passing mention in sources as a shadow archetype, good/bad in all of us vs good/bad personalities, the drinking of a potion he creates changes him so it's also see as a reference to alcoholism - but I can certainly add it if you think it important. - The end of the current section refers 2 surveys of psychiatrists from 20 years ago, can this be relocated maybe under Controversy? There are other similar surveys to mention, both references are primary sources, and at least one of the surveys has multiple different interpretations so the section needs expanding which I hadn't planned on looking at yet. - At the end of my draft section is a factual historical book by a psychiatrist about MKUltra, which is also on the current page. The book isn't particularly notable in popular culture compared to the others mentioned and isn't in my other sources. The book has been re-titled since too. Leave in or not? Amousey (they/them pronouns) (talk) 18:49, 10 July 2020 (UTC)

No strong opinion on the images.

Which surveys are you referring to? Flyer22 Frozen (talk) 02:22, 11 July 2020 (UTC)

How do I unarchive a thread? One able the surveys just got archived. The two surveys are both related surveys of psychiatrist opinions of the validity of DID as a diagnosis, and the evidence for it, one for the US and one for Canada, can't remember the first authors but I will call them Piper 1999 and Piper 2000. They make up the end of the popular culture section on the live page, which I'm just about to update with the other changes you've seen. Amousey (they/them pronouns) (talk) 20:18, 13 July 2020 (UTC)

You just go in the archives where the discussions were placed, revert the bot, and then re-add the discussions to the talk page. I was going to unarchive for you. But first I thought to ask: Why do you want them unarchived? You can just read them in the archive or link to them in the archive if wanting to make future points about what was stated in those sections. You can also simply start a new section on whatever matter was archived once we get to it. Flyer22 Frozen (talk) 06:13, 14 July 2020 (UTC)

Recent edits

Amousey, regarding this and this? I thought we weren't focusing on the medical aspects (well, outside of law or in relation to cultural aspects) right now. I reverted the "Special populations" section because we already have a "Children" subsection in the "Causes" section and an "Epidemiology" section that addresses young children and adults. Extra population data about children (or specifically teenagers) and the elderly can go there. If readers were to spot your "Special populations" section with the "Children" subheading, they might think that all of the population data on children is there, when, actually, it's also elsewhere in the article. If we were to use a "Special populations" heading, it could be a subsection of the "Epidemiology" section and the children and elderly material could be moved there...without unnecessarily adding "Children" and "Elderly" subsections within that. Still, I see no need to add a "Special populations" section simply because it's a heading option at WP:MEDSECTIONS. I noted before that WP:MEDSECTIONS does not relay strict guidance. One of the things it states is the following: "The given order of sections is also encouraged but may be varied, particularly if that helps your article progressively develop concepts and avoid repetition."

As for this, this and this? Even if the person who wrote that text got it wrong in relation to the source, the false allegation aspect has been brought up in sources on DID. So it's not just "an allegation." There is also the false allegation side. Flyer22 Frozen (talk) 03:37, 6 July 2020 (UTC)

I hadn't planned on doing further, but I had just read the Reinders article which was a reference in the legal section. Do you want the text to support the changes or would you prefer to find another source? The children section under cause is misleading - the heading implies children cause it. How would you feel about changing all the cause subheadings to improve accuracy and reflect consensus? Trauma, Early life stress, Sociocognitive (which the children part a applies to), Biological (I did find a source for this)?

Reading the sources, the issue is whether the allegation is correct or not, which is uncertainty, demonstrably false allegations aren't in the sources I have seen up to this point, and there are no epidemiological studies for proved false allegations cites. Reinders was notably misquoted in several places. Uncertainty and knowingly false were being conflated which wasn't the case in the source. The fact that some believe some allegations are false should be weighted against the evidence of that and the independence of those sources. Especially given a number of sources have been publicly criticized for charging huge sums to defend accused pedophiles or murders (not an ad hominen attack - I'm referring to specific cases - Harrison Pope, August Piper, Harald Merckelbach, Elizabeth Loftus if I remember correctly - legal cases are online for verification). Some of them have had their expert witness testimony criticized in court and disregarded by the judge as unscientific. Loftus wrote about defending Ted Bundy and OJ Simpson in one of her books, and has a 1970s paper on verified what she calls "repressed memory" of documented amnesia in cases of sexual assault/rape which if she cited it, it would impact her conclusions. Her work is mostly cited in advertising rather than psychiatry.

The various different psych organisations all produced statements on the issue of false memories but these are either missing or mentioned only in passing. I am not sure why there is undue weight on the false memories or why a syndrome that was never researched gets a large chunk of the page. The members of the now-defunct False Memory Syndrome Foundation never developed diagnostic criteria or research, so we cave say "here's the differences, here's the similarities " even. I left in what was not cited in error but I think it should be addressed at some point. It is given more weight than well proven comorbidities like PTSD, suicidality, depression, substance use/addiction. I hadn't wanted to address this yet, but corrections for Reinders were about accuracy and there wasn't any other source cited there.

As I referenced, the MOS for medicine states to include special populations - not population data but how the condition affects different subgroups, and there is material for elderly and especially for children and adolescents. The guidelines for children aren't referenced anywhere, and the most recent are dated 2004.

With children and adolescents - I honestly don't see how an entire group can be virtually left out - all page only casts doubt on the prevalence on children and nothing on the practical sure. There's enough material for a separate guidelines and notable research and cases. The elderly part could possibly be a subheading under adults. But for adolescents and children the diagnostic process, presentation, treatment and prognosis are notably different. There are also some books on the topic both academic and popular press.

What do you think on rethinking subheadings for the causes, and on where material for teens and children should go? Amousey (they/them pronouns) (talk) 23:37, 6 July 2020 (UTC)

You stated, "Do [I] want the text to support the changes or would [I] prefer to find another source?" Of course I don't want text there that is not supported by the source. My point is simply that we should not report on only one side. I stated that the "false allegation aspect has been brought up in sources on DID. So it's not just 'an allegation.' There is also the false allegation side." False allegations of child sexual abuse, just like false allegations of rape with regard to adults, are rare. In the case of children and false allegations, it's usually an adult who made the false allegation (saying the child was sexually abused) and/or an adult who spurred the child on to make the false allegation. As for DID specifically? Like this 2005 (reprint) "Mental Disorders, Medications, and Clinical Social Work" source, from Columbia University Press, page 72, when speaking on DID and child sexual abuse states, "Another concern may be the bias of the clinician, who may be overzealous in looking for evidence of sexual abuse and inadvertently lead the client, especially one who may be highly suggestible or eager to please, to 'remember' incidents that did not occur. Clinicians must be knowledgeable about the process of memory and repression and must also recognize their potential power to direct client thinking. Since 'recovered' memories may not always be accurate, it is important to obtain some supporting evidence from outside sources. While sexual abuse certainly occurs, so do false accusations that can lead to serious family disruption and even litigation." I know how you feel about the topic of false memories with regard to DID, but false memories have long been a concern regarding DID. And it is a fact that clinicians hold power to direct their client's thinking. The clinicians who are taught properly are told this, and to be cautious of it. They should not lead the patient.

You stated, "The children section under cause is misleading - the heading implies children cause it." I don't see it that way. But the material in that section is about diagnosis, symptoms, and whether causation/a causal link can be supported. So some of that material can be moved to the Diagnosis section, the "Signs and symptoms" section, and the "General" subsection of the "Causes" section. I don't see a need for extra headings.

You stated, "Reading the sources, the issue is whether the allegation is correct or not, which is uncertainty, demonstrably false allegations aren't in the sources I have seen up to this point, and there are no epidemiological studies for proved false allegations cites. Reinders was notably misquoted in several places. Uncertainty and knowingly false were being conflated which wasn't the case in the source. The fact that some believe some allegations are false should be weighted against the evidence of that and the independence of those sources. Especially given a number of sources have been publicly criticized for charging huge sums to defend accused pedophiles or murders (not an ad hominen attack - I'm referring to specific cases - Harrison Pope, August Piper, Harald Merckelbach, Elizabeth Loftus if I remember correctly - legal cases are online for verification)." This is where I repeat that we go by what the sources state. We include criticism when it is WP:Due to do that. We include both sides and do not pick a side. We only exclude a side when it is WP:Due to do so, and this should be based on what the literature explicitly states, such as whether a viewpoint falls under WP:Fringe, and/or whether the literature barely covers the topic. I've also mentioned that WP:Due is clear that we sometimes include views that fall under WP:Fringe, but we do this by giving them the appropriate weight (such as noting that the view is fringe and/or giving the piece just one sentence or just one paragraph, or just a couple or few paragraphs).

As for the rest regarding memories, we've already been over that above. I'd rather not debate it again. It's best to just refer to what I stated in those sections about going by what sources state, what WP:MEDRS states and allows, WP:Due weight, and so on.

You stated, "As I referenced, the MOS for medicine states to include special populations." It does not state that we must include a "Special populations" section. Population data is naturally covered in an epidemiology section. My view on the matter is stated above in this section. I stand by it.

You stated, "With children and adolescents - I honestly don't see how an entire group can be virtually left out [...]." I did not suggest that any population data be left out. As long as it's due, it can be added. We are discussing how to add it.

You stated, "The elderly part could possibly be a subheading under adults. But for adolescents and children the diagnostic process, presentation, treatment and prognosis are notably different. There are also some books on the topic both academic and popular press. What do [I] think on rethinking subheadings for the causes, and on where material for teens and children should go?" I did rethink this. I responded about the "Causes" section in this post. And, before this post, I previously stated that extra population data about children (or specifically adolescents/teenagers) and the elderly can go in the "Epidemiology" section. That is where the population data already is. There is no need to make a separate section addressing population data. The "Epidemiology" section could have a "Children" subsection, an "Adolescents" subsection, and an "Adults" subsection. But I'm usually not for creating subsections unless necessary. And by "necessary", I, for example, mean creating subsections when the section is big. If we are talking about creating a subsection for a little bit of material, then I'm against that per MOS:Paragraphs. Population data on children, adolescents/teenagers, and adults can be included in separate paragraphs of the "Epidemiology" section without subheadings for them.

Really, I'd rather not focus on all of this right now. Per our agreement earlier on the talk page, I'd rather just focus on the legal and society and culture material for now. One focus at a time. Flyer22 Frozen (talk) 21:21, 7 July 2020 (UTC)

Thanks for your detailed and thoughtful reply. I am sorry if it seemed that I went against what we discussed - that certainly wasn't my intention. Are you OK with where things are on the page at the moment or did you want some edits undone or markup added to indicate issues to deal with later?

I think it seems reasonably likely that there will be some incorrectly sourced material that comes to light when working on an unrelated section. How would you like that flagged up? And where?

I haven't actually given my view on false memories, or memory issues. My beliefs based on what I have read up until this point is that memory is unlikely to be 100% accurate or 0% accurate. False memories and inaccuracies have never been denied (not in what I have read anyway). But clinically in terms of treatment, what I have seen says that determining the accuracy of the memory is not a goal of treatment. There's no specific agreed manner to do so. The aim of treatment (whether that is medication, therapy or social support etc) is to address the psychiatric problems, help the person improve their own life. The goal of therapy for PTSD or for DID does not involve trying to "find" memories or some kind of detective work because that's a law enforcement role. Ultimately it's a medical page being written. Memory issues are dealt with in other pages, for example Psychogenic amnesia (aka dissociative amnesia) is both a separate diagnosis and a criteria of a DID diagnosis - so doesn't make much sense duplicating. There's a few particular memory issues with DID that aren't typically found in dissociative amnesia like forgetting how to do a familiar task (drive, tie shoelaces etc). On having amnesia for traumatic evidence, there's evidence from many sources that it happens. The earliest I know about is from combat - WWII - in which other soldiers witnessed a trauma but the person it happened to didn't remember / denied it.

Some of the clinicians very notable for working with patients with DID or with abuse survivors have said that they think it best not to let patients know their view on the accuracy of memories since patients may reveal something then later seek evidence to deny it, then repeat it again then convince themselves it wasn't true and remaining neutral while a patient sorts it out is more helpful for their recovery. Much of the memory research that gets referred to is unrelated to trauma so not comparable. (The "two types of memory" argument put forward is a strawman also but that's a discussion for another time).

With the False Memory Syndrome that was something that sounded credible at the start, but quickly became very apparent that it was not getting researched. It's never had a proposal for inclusion in the DSM. No Epidemiology. It's clearly Fringe so we should see whether it merits much mention and what space to devote to avoid undue weight. Getting into the details of the foundation's setup could possibly be reduced.

Thanks for rethinking on the children / adolescents, I will put some sources up.

Going back to the popular culture, I think that's close to finished. Do you have thoughts on the next topic to tackle? Amousey (they/them pronouns) (talk) 22:25, 7 July 2020 (UTC)

You stated, "The goal of therapy for PTSD or for DID does not involve trying to 'find' memories or some kind of detective work." This goes back to the source I cited above noting the "bias of the clinician, who may be overzealous in looking for evidence of sexual abuse and inadvertently lead the client, especially one who may be highly suggestible or eager to please, to 'remember' incidents that did not occur." Regardless of what the goal is, clinician bias and their power to direct client thinking may manifest in this way, just like clinician bias and their power to direct client thinking has happened with regard to other psychiatric disorders.

You stated, "Ultimately it's a medical page being written. Memory issues are dealt with in other pages [...]." And information about false accusations of child sexual abuse based on false memories can and should be included in this article with WP:Due weight. We can asses how much should be in the article at a later date.

You asked, "Do [I] have thoughts on the next topic to tackle?" I'll have to think on it. Flyer22 Frozen (talk) 05:20, 8 July 2020 (UTC)

Okay, I've thought on it. I think that our focus should be on the "History" section next. Getting the less controversial sections out of the way first. I could look for the sources this time. Flyer22 Frozen (talk) 02:25, 16 July 2020 (UTC)

Diagnosis section update

Hopefully this link will be enough to verify the change I just made. It looks like there was an original error in mentioning adults and some confusion over DSM-IV and DSM-5. I didn't see an alternative way of interpreting the info that fit with what was on the page so just did the correction by using words from the source. I couldn't find anything in the page or so explaining the diagnostic criteria either which might have suggested a mention of adults or age-related restriction. It's possible that there was some confusion with personality disorders which can't be diagnosed in childhood (DID being a dissociative disorder - even when called MPD it wasn't in the personality disorder chapter). I noticed elsewhere on the page or states rarely diagnosed in children rather than cannot be diagnosed in children. I hope that change will be ok with you. Amousey (they/them pronouns) (talk) 00:32, 17 July 2020 (UTC)

Primary sources - Surveys

The section below, part of the old society and culture section, has 2 (related) primary sources as the only sources, one 20 years and the other 21 years old. The summary in the page repeats heavily contested points made in the studies - [Talk:Dissociative_identity_disorder/Archive_12#Pope_1999_survey_on_the_validity_of_DID see talk page thread] - with responses commenting on a lack of scholarship, misleading conclusions, omissions of important details the publications, etc. It is also a bit odd to ask for DSM-5 opinions only 6 years after the DSM-IV was published - the DSM-5 was published 13 years after the surveys. The surveys found the majority of psychiatrists asked agreed that DID should be in the DSM although some were unsure or thought it should be removed.

Current text:
Surveys of the attitudes of Canadian and American psychiatrists towards dissociative disorders completed in 1999and 2001 found considerable skepticism and disagreement regarding the research base of dissociative disorders in general and DID in specific, as well as whether the inclusion of DID in the DSM was appropriate.

Can this content be removed given a) age, b) primary sources only, c) reliability issues over interpretation / misinterpretation, d) I don't think they add anything to the page that isn't already there. I search for other surveys and secondary sources - I couldn't find any recent secondary sources commenting on the various different surveys (including the newer ones). Other surveys are for either different countries, or different professions eg psychologists, mental health nurses not just psychiatrists, outside US. If the intention of referencing the surveys is to point out that some professionals are skeptical of the diagnosis, or that most accept it (as reflected by the DSM-5 and ICD-11), many aren't very aware of the evidence base for DID, or about validity then there's a variety of secondary sources already on the page that make those points. (Also I checked and no serious or detailed proposal was made to either remove DID from the DSM or ICD, change the categorization etc - only Paul Dell's very complex alternative diagnostic criteria were put forward.). Other surveys - American VA psychiatrists and psychologists in 1994, American Psychological Association 1999, UK 1998, Northern Ireland 2002, Isreal 2005, Australia 2005. Various other secondary studies comment on either the number of clinicians seen before a correct diagnosis, or years in mental health system before diagnosis (although that might be based on similarly old data). My questions are: whether to remove the bit on surveys directly. If not whether to simply summarize the points on acceptance and knowledge professionals have of DID using secondary sources - which would properly follow MEDRS, keep but address the lack of neutrality and expand to include the other surveys, if keeping them where to put it, or leave out/move to talk page for another time. I don't think it's useful to have the paragraph after the books and movies. Amousey (they/them pronouns) (talk) 00:05, 17 July 2020 (UTC)

It seems safe to remove that. It could also go in the "History" section. Flyer22 Frozen (talk) 03:19, 17 July 2020 (UTC)

I'm confused. Are you saying move to history, or remove, or leaving the decision to me? Amousey (they/them pronouns) (talk) 23:15, 18 July 2020 (UTC)

The history thing was just a suggestion. I'm leaving the decision up to you. Flyer22 Frozen (talk) 02:00, 19 July 2020 (UTC)

Updates

I did some small additions to the rights section today that I would not expect to cause issues. I think updating the diagnosis section would be pretty straight forward. Within that section it currently jas the main part - which explains difficulties / issues around diagnosis, and a Screening subheading that describes the diagnostic interviews and screening tools. I'd like to rename the Screening heading to something like "diagnostic process" or "diagnostic tools", or if not move the interview descriptions to a separate heading to be more accurate. Adult and teen/child diagnosis are considered together. I don't know whether this is better under a subheading - eg Children and adolescents. I can work in my sandbox as before if that would be helpful. Or create a draft on the talk page for joint editing. Amousey (they/them pronouns) (talk) 00:07, 25 July 2020 (UTC)

As seen in the Talk:Dissociative identity disorder/Archive 12#Recent edits section above, we have disagreed on how best to go about that section. You asked me what section I think we should work on next. I stated, "I think that our focus should be on the 'History' section next. Getting the less controversial sections out of the way first. I could look for the sources this time." Flyer22 Frozen (talk) 02:53, 25 July 2020 (UTC)

I misunderstood your comment on history. I will take a look. Amousey (they/them pronouns) (talk) 21:58, 25 July 2020 (UTC)

There are too many links, it looks messy.

That’s just it IgnoredCelery (talk) 17:35, 30 November 2020 (UTC)

Rights movement

User:LostGirl20 I'm currently working on the popular culture section which includes the rights movement. I thought you might want to contribute to that, it also links in with the movies / books section I am working in my sandbox here since it references Truddi Chase, whose film had a strong stance against integration. The DID treatment guidelines also refer to integration not being possible for some who may lack the money or time or have other complications that prevent them progressing beyond the first stage in therapy, or not being desirable for some, and Treatment goals being discussed as shared is in there (as opposed to being chosen by the therapist). I am not sure which other representations or sources would be helpful here - many of the authors never integrated fully eg Cameron West, Truddi Chase, and Robert Oxnam (who is less well known). In Frankie and Alice I don't know what happened after the movie but the movie mentions that they should try to get along. Astraes's web has some info on this I think. Amousey (they/them pronouns) (talk)

I tried updating the rights movement section a bit, I think it's improved considerably because it was too short compared to all other sections on this page. I will try to improve it further in the coming weeks. TruthSeekerSeven (talk) 21:29, 19 December 2020 (UTC)

ICD-11 and SCM issues

1. The ICD-11 is out now, and has given greater prominence to D.I.D. (it's no longer under "Other dissociative conversion disorders" F44.81, had been renamed from MPD, and 6B65 Partial dissociative Identity Disorder has been introduced - equivalent to the DSM's Other Specified Dissociative Disorder presentation 1.
2. I searched these pubmed reviews but couldn't find any recent reviews supporting the SCM. We should consider removing the SCM (sociocognitive)/iatrogenic (therapist caused D.I.D.) and fantasy model (caught it from a movie) due to lack of evidence. There's no Epidemiology showing the the SCM hypothesis is valid. Tiertary sources have either dropped it off don't mention it. Good quality secondary sources either don't mention it or give evidence against it - except those written by the handful of True Believers (Lynn, Lillifield, Merkelbach, McNally, and occasionally Boysen, Paris or Giesbrecht). It was a theory from the 1990s but is no longer notable. See Risks and Prognostic Factors in DSM-5 p533
3. NPOV - I suggest a rewrite if any sections related to cause or treatment based only on independent tiertary sources and high quality Systematic or other reviews and Meta-analysis from the last 5 years in keeping with WP:MEDRS. Possibly clinical guidelines for information that can't be found elsewhere. I suggest avoiding book chapters especially undergraduate textbooks since may are out of date with the APA saying many don't cover trauma, abuse or dissociative disorders correctly and in keeping with NPOV avoiding any sources that generated letters of complaint, or primary research. The full section on DID is these 8 pages, ICD-11 is a paragraph. The page already references the DSM moving Dissociative Disorders next to the Trauma and Stress-related Disorders chapter because of the link. The APA (Wilgus 2020) has documented errors and significant inaccuracies in many undergraduate textbooks so these are poor sources.
4. There should not be any claims that only child abuse causes DID: that's not what the sources say. They say repeated trauma or stress during childhood. Possible sources

1. ICD-11 (online)
2. ICD-10 (2017 version online)
3. Kate 2020. The prevalence of Dissociative Disorders and dissociative experiences in college populations: a meta-analysis of 98 studies.
   
4. Blihar 2020. A Systematic Review of the Neuroanatomy of Dissociative Identity Disorder
   
5. Lowenstein 2018. Dissociation debates: everything you know is wrong
   
6. Lotfini 2020. Structural and functional brain alterations in psychiatric patients with dissociative experiences: A systematic review of magnetic resonance imaging studies

— Preceding unsigned comment added by Amousey (talk • contribs) 21:20, 5 June 2020 (UTC)

Paracelsus

Adding a (dubious) tag. The article claims that "The first case of DID was thought to be described by Paracelsus in 1646." with a reference to a 2011 JAAPL paper at http://jaapl.org/content/39/3/402, which in turn relies on a 1991 paper described at https://psycnet.apa.org/record/1991-97920-007 but which is not online AFAICT. Meanwhile, Paracelsus died in 1541, according to his article.

Searching through some Google Scholar results, it looks like the "Paracelsus 1646" claim goes back to at least 1980 in the academic literature, and it's been repeated ever since by authors who didn't look up the man's date of death. — Mike Gogulski ^{↗C•@•T↗} 11:33, 26 January 2021 (UTC)

I have just removed the sentence:

   The first described case of DID was thought to be by Paracelsus in 1646. 

Jennifer Freyd could not find the source, despite attempting to find the original manuscripts - PDF link [2]. This seems to be sufficient cause to remove for the moment, and Freyd does not appear to have found any further information. As for what could replace this as the first recorded occurrence, I have found references to "Van der Hart, O., Lierens, R., & Goodwin, J. (1996). Jeanne Fery: A sixteen century case of Dissociative Identity Disorder. The Journal of Psychohistory, 24(1)". However, it seems that van der Hart did lose their license in 2020 for "transgressive behaviour"; I shall leave the question of the trustworthiness of this source to a more qualified editor. The rest of the paragraph works despite the absence of a first occurrence, nonetheless. 192.76.8.80 (talk) 13:41, 5 June 2021 (UTC)

References

Disease is not real allegation by 2001:8003:a8f9:0:6d5e:7228:b87f:a94c

@2001:8003:a8f9:0:6d5e:7228:b87f:a94c: could you provide sources where the disorder is fake, not real, fictitious? Thanks. SunDawn (talk) 06:29, 7 July 2021 (UTC)

Someone lock this page

I keep seeing reverts from this article. Can someone just lock it to prevent IPs from editing this?CycoMa (talk) 07:28, 7 July 2021 (UTC)

Out of the Shadows at Last

I removed this from the "Causes" - "General" section (I corrected the link):

According to an October 2020 editorial within the British Journal of Psychology titled "[(https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/dissociative-identity-disorder-out-of-the-shadows-at-last/8E2884FA8669A9A64790E5C47AD72DC7)%7CDissociative Identity Disorder: Out of the Shadows at Last]" the authors explain why the fantasy prone model continues to persist despite evidence against it:

"Although the trauma versus fantasy debate has evolved and aetiological research has broadened in the past few decades, there are several reasons why the fantasy model continues to appeal to clinicians. One reason is that information in undergraduate and graduate textbooks about trauma and dissociation is inadequate or simply wrong, because (a) it is often based on experimental research in non-clinical samples, (b) it is not fully based on scientific research, (c) it contains unbalanced discussions about the detrimental impact of childhood traumatisation and (d) it disregards empirical evidence showing a relationship between dissociation and antecedent trauma. Another reason is reluctance to accept the nature and severity of childhood abuse that individuals with DID report. It is troubling and painful to acknowledge how common and devastating trauma is, especially chronic childhood abuse. Subconscious protective mechanisms can take over to deny the reality of such abuse and to believe that DID is a factitious disorder, as stated by the fantasy model.1 However, it becomes increasingly apparent that severe childhood abuse, neglect and maltreatment are part of many psychiatric disorders and of our society."

The "Causes" section is subdivided into "General", "Developmental trauma", "Therapist-induced", and "Children". This paragraph advocates for one of the two models, so it does not belong in "General".

Moreover, it advocates not by giving reasons why the Developmental trauma model fits the facts better, but by thinking up reasons why the proponents of the Therapist-induced model disagree with it. That is really crappy reasoning. It is the same as theologicians dismissing atheists as ignorant of sophisticate theology, astrologers dismissing skeptics as dogmatic, 9/11 conspiracy theorists dismissing their opponents as part of the conspiracy, and so on. It is ignoring the facts and concentration on the person; poisoning the well it is called. But of course this has a big tradition in psychiatry, starting with Freud: when somebody disagrees with you, just analyze him away. As long as psychiatrists have to argue like this, real scientists will not take them seriously.

Unless this relatively new source has received reception, it does not belong in the article at all. --Hob Gadling (talk) 06:15, 6 June 2021 (UTC)

Hob Gadling, those edits were made by Desert-opal. People must have missed it, but Desert-opal added a bunch of non-neutral edits, removed large, relevant chunks, infused unencyclopedic language and copyright problems, and added external links in the body. Someone took care of some of the external links, but all the other changes were still there. I culled back all Desert-opal's edits just now. Material can be updated, but not like that. — Preceding unsigned comment added by Nowearskirts (talk • contribs) 19:49, 12 July 2021 (UTC)

Hello, MjolnirPants. You culled back fixes I made to the article. I'm not CarlPhilippTrump.me and my fixes to the article have nothing to do with that editor. They don't even support what that editor is arguing. The are serious issues with the edits made by Desert-opal. For example, you re-introduced blockquotes from individual doctors, lending entire blockquotes to their views, and you re-introduced external links on the page. There are also other issues. Please see this section on Talk. I saw the article when I was looking at "Recent changes." I read the talk page and saw what Hob Gadling said, and then I looked into the article's history and culled back Desert-opal's edits.

I'm not arguing with myself on the talk page. — Preceding unsigned comment added by Nowearskirts (talk • contribs) 18:26, 12 July 2021 (UTC)

Could you please WP:SIGN your contributions on Talk pages in the future? --Hob Gadling (talk) 05:41, 13 July 2021 (UTC)

Torture-based deliberate creation

The main cause of DID is torture no matter if some label it somewhat euphemistic "abuse" – its about electro-shocks, rape, and severe violence (see this edit). --CarlPhilippTrump.me (talk) 13:00, 12 July 2021 (UTC)

You're combining multiple sources - most of which are not reliable sources on the topic - to say something that isn't actually mentioned in any of the sources. The Clockwork Orange reference is not at all relevant and is written like this movie is somehow proof of... anything (more editorialization). And then there's the mentions of the Illuminati and Hollywood which... do these sources even MENTION DID in any way (I know for a fact that the "Gray Matters on Screen: Intelligence Agencies, Secret Societies, and Hollywood Movies" article doesn't even mention DID anywhere)? The bottom line is that the quantity of sources is irrelevant, what is relevant is that they actually support what you write about and that they're a proper, secondary medical source. As it stands pretty much none of what you wrote should be re-added.Megaman en m (talk) 13:46, 12 July 2021 (UTC)

1. All of my linked sources are relevant scientific publications (journals as well as books by respected publishing houses such as Routledge and Taylor & Francis).

2. Furthermore, check for yourself if the cited books and journals include the relevant key aspects of the relevant sentence where the sources were referenced:

a) Ritual Abuse and Mind Control. The Manipulation of Attachment Needs (2018): "Dissociative identity disorder" and "torture" are mentioned.

b) Becoming Yourself. Overcoming Mind Control and Ritual Abuse (2018): "Dissociative identity disorder" and "torture" are mentioned.

c) Healing the Unimaginable. Treating Ritual Abuse and Mind Control (2018): "Dissociative identity disorder" and "torture" are mentioned.

d) Trauma, Torture and Dissociation. A Psychoanalytic View (2018): "Dissociative identity disorder" and "torture" are mentioned.

e) The Alchemy of Wolves and Sheep: A Relational Approach to Internalized Perpetration in Complex Trauma Survivors (2013): "Dissociative identity disorder" and "torture" are mentioned.

f) The C.I.A. Doctors: Human Rights Violations by American Psychiatrists is not available on Google Books but here is a journal review discussing it (the name of an earlier print of the book used to be "The deliberate creation of multiple personality by psychiatrists": "MKULTRA" is mentioned.

g) Forensic Aspects of Dissociative Identity Disorder (2018): "Illuminati" is mentioned.

h) Mind Control 101 - How to Influence the Thoughts and Actions of Others Without Them Knowing Or Caring (2011): "Illuminati" is mentioned.

i) The Illuminati. Facts & Fiction (2009): "Illuminati" is mentioned.

j) Gray Matters on Screen: Intelligence Agencies, Secret Societies, and Hollywood Movies (2017): "intelligence agencies" and "secret societies" are mentioned.

k) Moral Panics: Culture, Politics, and Social Construction" (1994): "satanic ritual abuse" and "moral panics" are mentioned.

3. As it stands all of my cited sources are relevant and contain the cited key aspects. Therefore, please respect my edit and stop further deleting relevant sources. Have a good day indeed. --CarlPhilippTrump.me (talk) 16:26, 12 July 2021 (UTC)

I think you went about adding it the wrong way. All these people are culling back your edits, so you should think about that and talk it out. You're not accomplishing anything by battling them.— Preceding unsigned comment added by Nowearskirts (talk • contribs) 17:25, 12 July 2021 (UTC)

Have you noticed how half of your sources don't even talk about DID? This article is about DID and nothing else. Stop trying to force your desired narrative and start citing reliable secondary medical sources instead. Taking pieces from several sources and putting them together to say something that none of them actually mention directly is specifically not allowed and counts as original research, something which is strongly forbidden on Wikipedia.--Megaman en m (talk) 17:43, 12 July 2021 (UTC)

Some of the proposed sources are also promoting conspiracy theories and cannot be considered reliable. —PaleoNeonate – 18:51, 12 July 2021 (UTC)

agree w/ PaleoNeonate--Ozzie10aaaa (talk) 22:27, 13 July 2021 (UTC)

My linked sources "a-e" talk about "Dissociative identity disorder" and "torture". There are "conspiracy theories" about the deliberate creation of "Dissociative identity disorder" by secret societies / intelligence agencies etc. – we should mention that these theories exist no matter what you guys think of them. However, if you do not want to mention that there are conspiracies at all about "Dissociative identity disorder" then you should at least allow my sources a-e to be cited in the article. --CarlPhilippTrump.me (talk) 18:05, 19 July 2021 (UTC)

Looking at those sources, it appears that your argument is that, because these books were published by reputable publishers, and because they contain the words "torture" and "DID", they are necessarily RSes for linking the two concepts in this article.

That is categorically not true. The Lord of the Rings was published by a reputable publisher; this does not prove the existence of Balrogs. And all of the books contain the words "We", "are", "not" and "trustworthy," which I could, following your logic, use to establish that they're not reliable for anything. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 19:29, 19 July 2021 (UTC)

Well the mentioned publications are not fiction. --CarlPhilippTrump.me (talk) 08:45, 20 July 2021 (UTC)

That's debatable. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 13:07, 20 July 2021 (UTC)

No. Routledge / Taylor & Francis are academic publishers. --CarlPhilippTrump.me (talk) 17:15, 20 July 2021 (UTC)

I never said they weren't. I said it's debatable whether your sources are entirely non-fictional. And I said it sarcastically, if you didn't notice. I'm impugning on their reliability for claims of fact. Lots of academic publishers will publish academic works that aren't reliable for claims of fact. Being published by a reputable publisher is a necessary, but not sufficient condition to consider something an RS.

You should read the comments which have been made in response to your arguments and sources here, and try to understand those, rather than continuing to insist upon contested claims without bothering to address the reasons your claims are contested. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 17:18, 20 July 2021 (UTC)

Honestly, you are just bullshitting. Routledge / Taylor & Francis are academic publishers. So please clarify your "argument" and stop bullshitting. --CarlPhilippTrump.me (talk) 17:27, 20 July 2021 (UTC)

This comment is just you repeating yourself while ignoring what I said and adding emotive attacks into the mix. If you're trying to convince me that you're right, you're doing a poor job of it. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 17:45, 20 July 2021 (UTC)

Sorry, but you are mistaken: Routledge / Taylor & Francis ARE academic publishers NOT fiction as you suggested. So unless you present any argument I think I will update the article according to the current literature. --CarlPhilippTrump.me (talk) 18:19, 20 July 2021 (UTC)

You are repeating yourself still, and inserting words into my mouth, words which I have explicitly denied speaking. Are you even reading my comments? If so, you're very clearly not understanding them.

Your proposed edits have not garnered consensus, and you have already been blocked once for edit warring. If you pick it up again, you will be blocked for longer, possibly even indefinitely.

If you can't be bothered to engage with what's being said to you in this section, then I, too, will stop responding to you, and you will have lost your last chance to convince someone that your content is worth including. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 19:17, 20 July 2021 (UTC)

What you are doing is called gaslighting. There are academic books that I want to include in the article. You are not bringing any argument why this scientific literature should not be included other than time-consuming blabla. --CarlPhilippTrump.me (talk) 19:50, 20 July 2021 (UTC)

You should read that article, because it describes a very different thing to what I'm doing. I'm going to start ignoring you now, because I don't think you have anything to say worth listening to. I'll still be watching this article though, and I'll make sure that any inappropriate edit warring is handled properly. ᛗᛁᛟᛚᚾᛁᚱPants Tell me all about it. 20:41, 20 July 2021 (UTC)

"Traumagenic system" listed at Redirects for discussion

A discussion is taking place to address the redirect Traumagenic system. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 November 10#Traumagenic system until a consensus is reached, and readers of this page are welcome to contribute to the discussion. _signed, Rosguill ^talk 21:09, 10 November 2021 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2019 and 25 April 2019. Further details are available on the course page. Student editor(s): Paigewilson2020.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 19:37, 16 January 2022 (UTC)

Misuse of tags

There is widespread misuse of tags in this article, such as "Non-primary source needed" for citations that are secondary sources, incorrect "Failed verification" tags for citations that are supported by the source, etc. I have removed a few and will continue to evaluate the sources and tags in this article but due to the large number of them it would be helpful if others could pitch in. Due to the controversial nature of this diagnosis I think it is especially important that tags are not being misused in the article by editors with an agenda.

I'll give an example here:

The wiki text in question was "In 1993 a group of researchers reviewed both DID and borderline personality disorder (BPD), concluding that DID was an epiphenomenon of BPD, with no tests or clinical description capable of distinguishing between the two. Their conclusions about the empirical proof of DID were echoed by a second group, who still believed the diagnosis existed, but while the knowledge to date did not justify DID as a separate diagnosis, it also did not disprove its existence."

This passage was tagged "Failed verification" and "Non-primary source needed". From the source itself:

"In 1993, Lauer, Black, and Keen concluded that DID was an epiphenomenon of borderline personality disorder, finding few differences in symptoms between the two diagnoses. They described, rather, a 'syndrome' of symptoms that occurs in persons with disturbed personalities, particularly borderline personality disorder. They concluded that DID had 'no unique clinical picture, no reliable laboratory tests, could not be successfully delimited from other disorders, had no unique natural history and no familial pattern.' That same year, after yeoman's efforts to answer this question by empirically reviewing the literature, North et al concluded that the diagnosis has not been 'truly' validated, but yet they 'came to believe in its existence.' They stated, 'Current knowledge does not at this time sufficiently justify the validity of DID as a separate diagnosis', but this also does not disprove the concept."

Clearly it is not a primary source, as the author is reporting on research and analysis done by others. It also clearly does contain the information the citation claims it does. — Preceding unsigned comment added by FearlessLingonberry (talk • contribs) 19:12, 20 January 2022 (UTC)

It's time to talk about systems

Systems are becoming widespread. At this point, it seems to be mostly misinformation clashing with modern psychiatric practice. Websites like https://did-research.org/ make many claims and they are being circulated on the internet. We should address systems and their academic support. -trysten (talk) 17:35, 23 September 2021 (UTC)

"System" is an attempt to validate mental disorders such as DID as "perfectly healthy" human beings. That is an unacademic effort resulting in hundreds of people skipping treatment because "System" supporters say they are fine. What's next? Making Bipolar disorder okay? Schizophrenia? Psychosis? If "System" should appear on this page, then only in the form of a debunking paragraph. 2.55.189.129 (talk) 07:30, 27 October 2021 (UTC)

Functional plurality is a well-established and academic topic. Hyperwave11 (talk) 09:19, 16 November 2021 (UTC)

It is only unacademic to reject the language being used, especially since publications like the one you cited as wrong are major enough to have definitely recieved academic attention regarding this language had the issue been academic at all, so until you cite academics claiming this language is incorrect, you are the one pushing "an unacademic effort." William+7 (talk) 04:17, 3 December 2021 (UTC)

...Bipolar people are typically pretty high functioning... People with schizophrenia are also not people who aren't able to function unless it's highly problematic. That's like saying because someone has autism and are low functioning, they can't see the world because they can't talk. And then that would move on to mute people being hospitalized, and then deaf people, et cetera. As a system alter, can I say, we are highly functioning. So are all our friends who are systems. Because guess what? We are just multiple people. We may be in one body, but that's like saying two best friends, for example, who never separate. I'm saying sleepovers every night, same school, same classes, et cetera, need to be hospitalized and never see anyone else. When they weren't hurting anyone. Do better and realize what you say is hurtful. /srs ): -Isabela Skeleton RemusSandersRegretsEverything (talk) (pronouns) 16:56, 27 January 2022 (UTC)

Why should the term "system" be unused? I personally have DID and my therapist refers to us as a "system". Most systems are also not skipping treatment, we work with therapists to be able to better function as people even if integration is not the goal. Honestly the overly clinical tone that I see sometimes that insists that people with DID are a singular entity and that the alters are simply "personas" etc. is fairly harmful, or at the very least feels incredibly othering, as it implies that the other headmates are less of a person than someone who's singular, if that makes sense. I apologize if any of this is worded/formatted poorly by the way, I am a new user here! LialaOkami (talk) 06:32, 10 January 2022 (UTC)

1.5% of the general population?

There'd be one kid with it in every other kindergarten class; there's absolutely no way that number is correct. It's obviously an anecdotal account on my part but I imagine the population of people who have heard a credible story about someone with DID might be closer to that percentage.

I'd hope the obvious inaccuracy would draw into question whether the cited sources for this statistic and the (hardly) more reasonable 3% of psychiatric patients are actually reputable sources but I'm not sure how to go about correcting this personally. — Preceding unsigned comment added by 70.48.238.246 (talk) 05:08, 21 April 2022 (UTC)

I was going to comment on that. Obviously this is a highly controversial topic, but the idea that DID in the conventional sense occurs at double the rate of schizophrenia seems extremely dubious. I strongly suspect that this has to do with the tests used, but I worry that that would be considered OR. At least there should be some sources stating how much of this figure actually have (according to proponents of the trauma model) genuine multiple identities. --Eldomtom2 (talk) 20:19, 22 April 2022 (UTC)

Agreed that it seems unlikely, but let me bring in another reason for questioning this: The lede says "It is believed to affect about 1.5% of the general population (based on a small US community sample) and 3% of those admitted to hospitals with mental health issues in Europe and North America." For those two numbers to be correct, half the general population would have to be "admitted to hospitals with mental health issues in... North America." And I doubt that number is correct. Mcswell (talk) 01:43, 25 April 2022 (UTC)

For what it's worth, 1.5% is the prevalence that is given in the Diagnostic and Statistical Manual of Mental Disorders 5th ed (DSM-V), which is almost certainly where that number came from...I don't know about the 3%. It's worth noting that what the public thinks of as "multiple personalities" would make up a small minority of that; also from the DSM-V entry: "Most individuals with non-possession-form dissociative identity disorder do not overtly display their discontinuity of identity for long periods of time; only a small minority present to clinical attention with visible alternation of identities." It's natural that the most severe cases are the ones that stick with people, but they're really outliers on one extreme of a spectrum. FearlessLingonberry (talk) 23:18, 4 August 2022 (UTC)

Quack therapists using dubious techniques such as hypnosis, leading questions and recovered-memory therapy (techniques which also lead to clients remembering former lives, Satanic ritual abuse and abduction by aliens) tend to diagnose DID without any care for actual truth, and they spread fantasy incidence numbers. Maybe those numbers are still tainted by input from such people. --Hob Gadling (talk) 09:10, 5 August 2022 (UTC)

Possibly, the DSM is certainly not infallible, but it is generally a reliable source for information on mental disorders. If a better, more reliable source is available, by all means use it. FearlessLingonberry (talk) 23:44, 5 August 2022 (UTC)

wot?

"While proponents note that DID is accompanied by genuine suffering and the distressing symptoms, and can be diagnosed reliably using the DSM criteria, they are skeptical of the traumatic etiology suggested by proponents.[48] " 2600:1700:DF50:A1F0:542D:98C3:CB1F:C6F (talk) 22:25, 25 September 2022 (UTC)

this article contradicts itself on the relevance of childhood trauma

i see this every few paragraphs "Research overwhelmigly links DID with claims of childhood trauma, abuse, or sexual abuse (though the reliability of these claims has been disputed)"

followed by a ref to p.363 of some textbook with no google books preview or a ref to some unspecified section of a paywalled academic article

is the dispute of the childhood trauma relation to DID even prominent enough to include here or does it add up to giving anti-climate-change scientists weight in the climate change article?

this seems to be contradicted so often in the article that if the dissent is justified, the debate deserves its own section or perhaps article altogther

then again, there seems to be a clear consensus here. pick a side wikipedia!! 2600:1700:DF50:A1F0:542D:98C3:CB1F:C6F (talk) 22:52, 25 September 2022 (UTC)

Dissociative Disorder

Does The disorder have to be defined as having different personalities? Can’t it just be a person experiencing acute disassociation from reality due to severe childhood trauma and neglect? How do you determine the difference in a person who is using the coping mechanism of compartmentalizing vs multiple personalities? I think of Eve, a patient of Dr. Cleckie from Augusta Georgia, and how it has affected how I saw DID. Does it have to manifest like that always or Is it possible that the multiple personalities could also be multiple compartments that aren’t necessarily “personalities “ but rather multiple instances of disassociating? Can a person be on a spectrum where the compartments haven’t been distinguished as personalities but rather just disassociating from reality? 2601:100:8000:B6C0:155E:81EF:2504:90A (talk) 14:13, 11 October 2022 (UTC)

DID is not the only disorder to experience disassociation. OSDD, PTSD, and BPD all deal with some level of disassociation. And if we look at the theory of disassociation those with OSDD, PTSD, and BPD, have emotional parts (EP)! :) Alex8317 (talk) 20:11, 12 October 2022 (UTC)

Therapist induced DID

Dissociative identity disorder cannot be therapist induced and the idea is old misinformation. The theory most likely exists because inappropriate therapeutic interventions can exacerbate symptoms if used with DID patients. However, no research evidence suggests that inappropriate treatment creates DID. Studies indicate that dissociative symptoms and a history of severe childhood trauma are present long before DID is suspected or diagnosed. A study conducted with a “normal” sample of college students showed that students could simulate DID. That study, by Spanos and colleagues, documents that students can engage in identity enactments when asked to behave as if they had DID. Nevertheless, the students did not actually begin to believe that they had DID, and they did not develop the wide range of severe, chronic, and disabling symptoms displayed by DID patients. Whereas, again, no study in any clinical population supports the idea that therapists/inappropriate treatment cuase dissociation. Alex8317 (talk) 19:53, 12 October 2022 (UTC)

It is undeniable that MPD/DID have elicited controversy over the years and that should be included in this article. I think an argument could be made that discussion of the iatrogenic hypothesis should go into a controversy section, rather than listed as a cause, and that should include counter-arguments. I also tend to think we ought to be careful with language like "among the most controversial" since such claims are difficult to substantiate and sources making them are generally part of the debate itself (that is, they aren't exactly unbiased and rarely base such claims on actual research). DID has certainly been controversial at times, but I'd stick to just that ("DID has been controversial, here are x, y and z arguments about it...") and avoid "ranking language" ("DID is the most/among the most/super duper extra controversial...").

I don't think you're entirely off-base @Alex8317, but simply deleting large chunks of the article is unlikely to get consensus. Instead I'd consider what specific edits you want to make and offer up sources for them. I would also recommend using peer-reviewed secondary sources - not only is it wiki policy for medical articles but it also helps cut through misinformation that is often found in the popular press. Off the top of my head, Dalenberg et al.'s 2012 "Evaluation of the Evidence for the Trauma and Fantasy Models of Dissociation" in Psychological Bulletin and Loewenstein's 2018 "Dissociation debates: everything you know is wrong" in Dialogues in Clinical Neuroscience would be good places to start. Please feel free to drop me a line at my page (see sig) if you need copies of these or any other articles you find.

Good luck and happy editing!

Donna's Cyborg🏳️‍⚧️(talk)(contribs) 13:50, 13 October 2022 (UTC)

Dispute over sourcing from Psychology Today for TikTok claim

@Tdmurlock: Please see RSN history for Psychology Today. I'm not reverting and will leave it to someone else to potentially do so, because it is a source that has been cited elsewhere on Wikipedia (when it's printed magazine editions, but not blogs, and when it's uncontroversial claims), but there is some controversy to using Psychology Today blogs in particular as WP:RS. See also Wikipedia:WikiProject Academic Journals/Journals cited by Wikipedia/Questionable1#40 where there's discussion of Psychology Today. Happy to take discussion to WP:RSN if you have further questions. Lizthegrey (talk) 11:45, 28 February 2023 (UTC)

As discussed, taking it to WP:RSN#Psychology Today blog citation on Dissociative identity disorder so that uninvolved editors can chime in, because I feel I can no longer objectively assess having gotten into a separate editing dispute over LGBT categorisations with you. Lizthegrey (talk) 21:39, 28 February 2023 (UTC)

(from RSN) I've removed the sentence, mostly because it fails WP:V but also WP:DUE. The source doesn't say that DID experienced a "surge driven by a small number of influential people on TikTok", the quoted portion is misquoted. What the source says is "Much of this seems to be driven by a small number of influential people on TikTok", and the qualifiers "much of" and "seems" are crucial. One psychiatrist saying there was a DID surge driven by TikTok might be DUE for inclusion, but one psychiatrist saying that much of a surge seems to be driven by TikTok is not DUE for inclusion. That's just somebody's hot take in a magazine, it's not like the result of a study in a peer-reviewed journal or anything like that. Levivich (talk) 23:44, 28 February 2023 (UTC)

Breaking the logjam on adult DID diagnosis & comorbidities

There's been a fair bit of disruptive editing as of late. I'm going to start assembling potential scholarly articles in the refideas template at the top of the article and encourage others to do a sweep of the literature since 2010 to look for reliable sourcing on comorbidity & relationship of DID to (childhood) trauma so that we can stop having folks disrupt the article with original research or the talk page with "this is clearly wrong but I can't substantiate why". Lizthegrey (talk) 03:58, 15 February 2023 (UTC)

Hi @LibertyWolf, I have a new assignment for you should you choose to accept ;) this is an area where people have edit warred in the past and I'm suspecting you'd be better positioned than I would as an expert in the field to find whether there are other viewpoints in peer-reviewed journals that disagree with the article's current statement that so far, reliable sources are in agreement that DID only can arise out of childhood trauma. The article currently says: DID is the result of repeated or long-term childhood trauma, most frequently child abuse or neglect, that is combined with an insecure or disorganized attachment. DID cannot form after ages 6–9 because individuals older than these ages have an integrated self identity and history (but then the second sentence is unsourced/missing citation). Lizthegrey (talk) 06:13, 5 March 2023 (UTC)

I totally accept, thank you @Lizthegrey. I was actually working my way to editing that. The common idea on Dissociative Identity Disorder only arises due to childhood trauma isn't actually accurate. It does commonly arises due to childhood trauma but not exclusively. It can arise from many reasons but not as common as childhood trauma. It can in fact arise in adolescence or adulthood but the older you are the more difficult it is to happen and more likely you'll develop cptsd and or bpd and or Schizotypal. It's still largely not quite clear why the brain processes trauma into Dissociative Disorders, trauma disorders, and personality disorders but it's claimed that the more fragile the mind the more likely you'll develop DID, which is why childhood trauma is more common in developing DID. below is the comment I shared on a YouTube channel that curious on the same thing.

"I have been diagnosed with Dissociative Identity Disorder (DID), Complex PTSD, and Schizotypal Disorder, and I might possibly also have BPD.

DID is strongly associated with interpersonal and environmental trauma. It's not exclusively caused by interpersonal and environmental trauma. It can be caused by things like; Temporal Lobe Epilepsy, Aracnoid Cysts, a Traumatic Brain Injury, Brain Cancer, PTSD/CPTSD, etc. DID is a Dissociative Disorder not a trauma disorder. In the DSM and ICD it's classed as a Dissociative Disorder and it doesn't have trauma as a key feature for diagnosis, nor does DID have to come from childhood; meaning it's not exclusively a developmental disturbance, either.

And yes, one alter can have type 2 diabetes, while another has a need for glasses but the host has no ailments, for example. Eye color can even change from alter to alter, too, (mostly shade of color) as another example. Alters can have their own mental health ailments or their versions of mental health ailments, as another example. Yes, it's also very possible for 2 or more alters to co-host or "take the light at the same time". Rapidly switching happens more for some than others.

Movies like Split and My Soul To Take are just a horror perspective of DID. They took alot of liberties to entertain you but took almost no responsibility in educating you on DID. Hollywood does that pretty often, not their fault though (although, i wish they were more responsible because those in the mental health community are left to pickup the pieces, each time). It should be rule of thumb to go to online mental health communities to understand mental health disorders in general. Also to understand Hollywood just wants to entertain you not educate you. my understanding, and the reality of current science, no, you can not climb walls like a lizard like in the movies Split or Glass.

But shows like Moon Knight and United States Of Tara did a really good job of educating audiences of DID while entertaining us. A really good representation of DID in media, in my opinion, is A&Es Many Sides Of Jane.

If Cinema Therapy is able to do episodes on United States Of Tara, My Soul To Take, Drop Dead Fred, and Many Sides Of Jane - that would be awesome. Epic even.

If anyone is interested check out these medical links on DID they talk about what I explained. The only difference is doctors are saying it, too. Also, I'm a Mental Health Blogger working on becoming a Certified Mental Health Educator. What I do is blog about different mental illnesses and resources that can help.

Some Links:

• https://pubmed.ncbi.nlm.nih.gov/7294186/
• https://pubmed.ncbi.nlm.nih.gov/2350225/
• https://pubmed.ncbi.nlm.nih.gov/2760599/

LibertyWolf (talk) 15:54, 5 March 2023 (UTC)

Thanks, @LibertyWolf. I've added the links you added to the "to reference" list above. Lizthegrey (talk) 02:52, 6 March 2023 (UTC)

introduction / foreword addition suggestions

 Dissociative Identity Disorder (DID) is a DSM-5 and DSM-IV-TR, Merck Manual, and ICD 10 and ICD 11 complex Dissociative Disorder. The common idea on Dissociative Identity Disorder only arises due to childhood trauma isn't actually accurate. The DSM, ICD and Merck Manual do not state that Dissociative Identity Disorder is trauma exclusive or childhood trauma exclusive. DID does commonly arises due to childhood trauma but not exclusively. It can arise from many reasons that are not as common as childhood trauma. Other extreme complex traumas such as combat in wars, natural disaster, cult and occult abuse, loss of a loved one or loved ones, human trafficing, extreme medical diagnosises (eg. Rare brain cancers, Aracnoid Cysts, Temporal lobe epilepsy and Geschwind syndrome, traumatic brain injury) or surgeries, extreme family conditions, and a combination of traumas could all cause an already fragile mind to split into multiple personality states. Dissociative Identity Disorder can also in fact arise in adolescence or adulthood but the older you are the more difficult it is to develop and it's more likely you'll develop cptsd, adjustment disorders, and or Schizotypal the older you are. It's still largely unclear why the brain processes trauma into Dissociative Disorders, trauma disorders, adjustment disorders, and personality disorders but it's claimed that the more fragile the mind the more likely you'll develop DID under factors of stressors and trauma, which is why childhood trauma is more common in developing DID.

• https://www.merckmanuals.com/professional/psychiatric-disorders/dissociative-disorders/dissociative-identity-disorder
• https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Dissociative-Disorders
• https://www.mcleanhospital.org/essential/did
• https://www.cambridge.org/core/journals/bjpsych-advances/article/understanding-identifying-and-managing-severe-dissociative-disorders-in-general-psychiatric-settings/62CC0133915C7F47CDAFADC230EE5001
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293161/
• https://www.msdmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/adjustment-disorders
• https://www.sciencedirect.com/science/article/abs/pii/S2352552519300118
• https://pubmed.ncbi.nlm.nih.gov/7294186/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219949/
• https://pubmed.ncbi.nlm.nih.gov/7294186/
• https://pubmed.ncbi.nlm.nih.gov/2350225/
• https://pubmed.ncbi.nlm.nih.gov/2760599/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338656/

— Preceding unsigned comment added by LibertyWolf (talk • contribs) 00:40, 7 March 2023 (UTC)

@Lizthegrey what do you think? Did I also post it in the right place? LibertyWolf (talk) 01:36, 7 March 2023 (UTC)

Correct place, I'll try to have a look in the next few days, but also am curious what other editors think. Can you indicate where each citation would be used to support which part of the text? In general we try not to have large blocks of text followed by large numbers of citations, but instead do inline citations a phrase or sentence at a time. Lizthegrey (talk) 02:00, 7 March 2023 (UTC)

One starting place: Dissociative Identity Disorder (DID) is a DSM-5 and DSM-IV-TR, Merck Manual, and ICD 10 and ICD 11 complex Dissociative Disorder should read something like: Dissociative Identity Disorder (DID) is a member of the family of dissociative disorders classified by the DSM-IV, DSM-V-TR, ICD 10, ICD 11, and Merck Manual. I'd also read over WP:DUE - there are sources claiming DID can't form before childhood, so instead of saying the common idea ... isn't actually accurate, instead try There is disagreement about whether.... See WP:DUE and WP:NPOV for guidance. Lizthegrey (talk) 02:09, 7 March 2023 (UTC)

I like your edits better, I wanna go with those. Thank you, @Lizthegrey.

Also what's up with this? "If a viewpoint is held by an extremely small minority, it does not belong on Wikipedia, regardless of whether it is true, or you can prove it, except perhaps in some ancillary article." LibertyWolf (talk) 15:20, 7 March 2023 (UTC)

that's WP:FRINGE, and not applicable here I think. it's mainly to combat pseudoscience, etc Lizthegrey (talk) 18:36, 7 March 2023 (UTC)

WP:FRINGE applies also to non-pseudoscientific "alternative theoretical formulations", ie anything without mainstream acceptance (which doesn't necessarily mean it's wrong, as the guideline gives examples like continental drift). Here, it would apply to explanations outside the mainstream view, and mostly just requires ensuring they're contextualized as such. Bakkster Man (talk) 20:58, 8 March 2023 (UTC)

Dissociative Identity Disorder (DID) is a member of the family of dissociative disorders classified by the DSM-IV, DSM-V-TR, ICD 10, ICD 11, and Merck Manual. There are sources claiming DID can't form after childhood, and that Dissociative Identity Disorder is childhood trauma exclusive but there is disagreement about that.

The DSM, ICD and Merck Manual do not state that Dissociative Identity Disorder is trauma exclusive or childhood trauma exclusive. DID does commonly arises due to childhood trauma but not exclusively. "The disorder may begin at any age, from early childhood to late life."- Merck Manual

Dissociative Identity Disorder can arise from many reasons that are not as common as childhood trauma. Other extreme complex traumas such as combat in wars or attachment disturbance, natural disaster, [adversity], [cult] and [occult] abuse, loss of a loved one or loved ones, [human trafficing], extreme medical diagnosises (eg. rare brain cancers, Aracnoid Cysts, [Temporal lobe epilepsy] and [Geschwind syndrome], [traumatic brain injury]) or surgeries, extreme family conditions, and a combination of traumas could all cause an already fragile mind to split into multiple personality states. "Some patients have not been abused but have experienced an important early loss (such as death of a parent), serious medical illness, or other overwhelmingly stressful events."- Merck Manual

Dissociative Identity Disorder is more difficult to develop in someone older. It's more likely you'll develop cptsd, adjustment disorders, BPD and or Schizotypal because the mind is less fragile, you have a better integrated self-perception and Identity, and your attachment style is more stable, as it is claimed. It's still largely unclear why the brain processes trauma into Dissociative Disorders, trauma disorders, [adjustment disorders], and personality disorders., You'll likely develop DID under factors of stressors, attachment disturbance, and trauma, which is why childhood trauma on fragile minds are also more common in developing DID. LibertyWolf (talk) 20:46, 8 March 2023 (UTC)

Woah it automatically added citations and references, didn't think it would do that. But I'll add proper citation when it's the final approved version, too. LibertyWolf (talk) 20:51, 8 March 2023 (UTC)

@[User:Lizthegrey] LibertyWolf (talk) 20:53, 8 March 2023 (UTC)

References

Infobox size

@LibertyWolf the infobox is getting a little big, if you had to prioritise the top 5 things in each category, what would you pick? We can move the rest to prose in the main article body. Lizthegrey (talk) 03:07, 10 March 2023 (UTC)

i'm all done with the infobox i added everything to it. can everything stay as is? also i wrote out the intro / overview in addition to the other suggestion.

Dissociative Identity Disorder (DID), which was previously named Multiple Personality Disorder, and commonly referred to as Split Personality Disorder or Dissociative Personality Disorder. Dissociative Identity Disorder (DID) is a member of the family of dissociative disorders classified by the DSM-V, DSM-V-TR, ICD 10, ICD 11, and Merck Manual for diagnosis. Dissociative Identity Disorder is characterized by primarily Dissociative Disorder symptoms, secondary key symptoms are shared with complex PTSD, Borderline and Schizotypal Personality disorders and tertiary key symptoms are shared with fibromyalgia, sleep disturbances, eating disorders, and body dysmorphic symptoms. Personality states alternately show in a person's behavior; however, presentations of the disorder vary. Dissociative Identity Disorder is usually caused by excessive and unendurable stress and or trauma, which commonly happens in childhood. The sense of a unified Identity develops from a variety of experiences and sources. In a child who is overwhelmed, the factors that should've blended together or become integrated overtime instead remain separate. Childhood adversity and abuse often leads to the development of Dissociative Identity Disorder, but not exclusively. LibertyWolf (talk) 03:39, 10 March 2023 (UTC)

Oh, very nice writeup there. Probably will need to triple-check it for sourcing and to make sure every statement there is substantiated by the sources but it looks like you are well on track to having a balanced, well-written lede. Give me another day or so to think about it, wikipedia is a side hobby and not a day job to me. Lizthegrey (talk) 03:56, 10 March 2023 (UTC)

Thank you so much for working with me, Lizthegrey. I really appreciate your time. Any time you can spare to help me is perfect. Thank you again. LibertyWolf (talk) 08:59, 10 March 2023 (UTC)

also no one is adding any feedback should we just add the changes for folks to comment or changes things? @Lizthegrey LibertyWolf (talk) 03:42, 10 March 2023 (UTC)

I'm not understanding your redaction this time

My see also section was redacted for being in the wrong place, now they aren't reliable sources? @Nikkimaria

LibertyWolf (talk) 03:27, 13 March 2023 (UTC)

DID is caused by childhood trauma

This Wikipedia article claims that Dissociative Identity Disorder is not just caused by childhood trauma. While typically DID is diagnosed in adulthood and adults learn about it, it cannot form then.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719457/#:~:text=The%20typical%20patient%20who%20is,about%20the%20age%20of%206. Here it says that DID has an onset of five to ten years old.

While this is the only research I can find, all other websites that claim it can develop at any age don't seem to cite sources. I would believe that these websites are including the age of diagnosis, which is different from the age of onset.

While not a true source, within spaces that deal explicitly with DID, it can only develop in childhood (although the exact ages vary slightly).

Also, this article seems to say that it can be caused by other things than trauma but never specifies anything that isn't trauma. Whoever wrote this appears to be mistaking trauma to mean abuse, which is not true. DID is, by its very nature, is a disorder caused by childhood trauma (abuse or not).

Shortened: DID is most definitely trauma-based, and it is highly likely to only form in childhood. This article should, at the very least, be indecisive. ComradeStutav (talk) 18:36, 16 March 2023 (UTC)

Rewording a confusing sentence

I think the wording of the following sentence is confusing:

• People likely develop DID under factors of stressors, attachment disturbance, and trauma, which is why childhood trauma on fragile minds are also more common in developing DID.

It might be clearer if it was reworded to something like this:

• People are more likely to develop DID because of factors such as stressors, attachment disturbances, and trauma, especially when they occur during early development, which is why childhood trauma is so common among DID patients.

Does this look reasonable? NoProtocolUnit (talk) 18:26, 19 March 2023 (UTC)

This page has been vandalized and needs redoing

Over the past couple months, this page has been vandalized and trashed. The introduction section doesn't even explain what DID even is according to the DSM, it just lists off other disorders it shares symptoms with. Under the "Cause and diagnosis' section, there's just the old introduction copy and pasted. I think all of these recent overhauls need to be undone, and there seems to be nobody moderating this page because it's a complete mess right now. Imphyyy (talk) 00:23, 6 April 2023 (UTC)

Nobody WP:OWNs it. be WP:BOLD and correct issues you see. Lizthegrey (talk) 00:32, 6 April 2023 (UTC)

Concerned about recent changes

Like @ComradeStutav above, I'm concerned about this Wikipedia article's claims about the etiology of dissociative identity disorder. I'm also concerned about some sources and how they are being used. I actually made this account recently so I apologize if there is any sort of etiquette I'm misunderstanding! I just wanted to open up an honest discussion about this and see what the people working on this article think? Below, I will quote parts of the Wikipedia article and then write up what I think about them.

• "The DSM, ICD and Merck Manual do not state that Dissociative Identity Disorder is trauma exclusive or childhood trauma exclusive. DID does commonly arises due to childhood trauma but not exclusively. "The disorder may begin at any age, from early childhood to late life."- Merck Manual"

It's true that the DSM-5, ICD-11, and Merck Manual all state that DID symptoms can onset at any age. However, the onset of noticeable symptoms does not indicate what causes a disorder. Onset and etiology are entirely separate constructs in psychology. This is why all of the sources listed (DSM-5, ICD-11, and Merck Manual) separately discuss the onset of DID and its etiology (or risk factors). To better understand why one disorder can have onset at different times, it can be best to look at PTSD. PTSD, for example, does not need to onset immediately after the traumatic event. A child who experienced a traumatic event may not develop noticeable PTSD symptoms until much later in life. The delayed onset of their PTSD does not imply that it wasn't caused by the traumatic event in their childhood.

Secondly, I have looked through all of these sources and I can't find any mention of DID being able to develop from something unrelated to trauma or adversity. In fact, these sources only mention DID developing from trauma and adversity! Here are some quotes below:

"In the context of family and attachment pathology, early life trauma (e.g., neglect and physical, sexual, and emotional abuse, usually before ages 5–6 years) represents a risk factor for dissociative identity disorder. In studies from diverse geographic regions, about 90% of the individuals with the disorder report multiple types of early neglect and childhood abuse, often extending into late adolescence. Some individuals report that maltreatment primarily occurred outside the family, in school, church, and/or neighborhoods, including being bullied severely. Other forms of repeated early-life traumatic experiences include multiple, painful childhood medical and surgical procedures; war; terrorism; or being trafficked beginning in childhood. Onset has also been described after prolonged and often transgenerational exposure to dysfunctional family dynamics (e.g., overcontrolling parenting, insecure attachment, emotional abuse) in the absence of clear neglect or sexual or physical abuse," (DSM-5 TR, p.333).

"Dissociative Identity Disorder is commonly associated with serious or chronic traumatic life events, including physical, sexual, or emotional abuse" (ICD-11, "Additional Clinical Features").

"Children are not born with a sense of a unified identity; it develops from many sources and experiences. In overwhelmed children, many parts of what should have blended together remain separate. Chronic and severe abuse (physical, sexual, or emotional) and neglect during childhood are frequently reported by and documented in patients with dissociative identity disorder (in the US, Canada, and Europe, about 90% of patients). Some patients have not been abused but have experienced an important early loss (such as death of a parent), serious medical illness, or other overwhelmingly stressful events" (Merck Manual, "Etiology of Dissociative Identity Disorder").

If the Wikipedia article wants to claim that DID does not need to be caused by trauma or adversity, it needs to provide reliable sources for that. The DSM-5, ICD-11, and Merck Manual do not support this claim in my opinion.

• "Dissociative Identity Disorder can arise from many reasons that are not as common as childhood trauma. Other extreme complex traumas such as combat in wars or attachment disturbance, natural disaster, adversity, cult and occult abuse, loss of a loved one or loved ones, human trafficking, extreme medical diagnoses (eg. rare brain cancers, Aracnoid Cysts, Temporal lobe epilepsy and Geschwind syndrome, traumatic brain injury) or surgeries, extreme family conditions, and a combination of traumas could all cause an already fragile mind to split into multiple personality states. "Some patients have not been abused but have experienced an important early loss (such as death of a parent), serious medical illness, or other overwhelmingly stressful events."- Merck Manual"

The article lists some additional causes to DID here. Among these, the article states that medical conditions such as epilepsy and brain injuries can cause DID. However, this directly contradicts the DSM-5's diagnostic criteria for DID. According to Criteria E, DID can only be diagnosed if "the symptoms are not attributable to the physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or another medical condition (e.g., complex partial seizures)" (DSM-5 TR, p.331). Temporal lobe epilepsy is also specifically mentioned in the exclusion criteria within the older version of the manual, the DSM-IV.

Many of the sources given for these medical conditions (in the infobox) are very old. I believe they come from before this exclusion criteria was even created or being widely used. I believe it is important for this Wikipedia article to have recent and updated information on DID, and I don't think that including these medical conditions as causations reflects that!

• "Dissociative Identity Disorder is more difficult to develop in someone older. It's more likely for adults to develop CPTSD, adjustment disorders, BPD and or StPD because the mind is less fragile, they have a better integrated self-perception and Identity, and their attachment style is more stable, as it is claimed. It's still largely unclear why the brain processes trauma into Dissociative Disorders, trauma disorders, [adjustment disorders], and personality disorders., People likely develop DID under factors of stressors, attachment disturbance, and trauma, which is why childhood trauma on fragile minds are also more common in developing DID."

I would love to see more sources for this. I don't feel like this Wikipedia article is a place for speculation or hypothesizing, right? The onset of DID in adulthood is a well-documented phenomenon, but I have yet to see any sort of reliable research about the etiology of DID coming from adulthood. The bulk of literature seems to debate more on how young one must be to develop DID, actually! Here are a few sources:

https://doi.org/10.2147/PRBM.S113743

"DID is currently understood as a chronic complex post-traumatic developmental disorder where adverse experiences usually begin in early childhood and in which the dissociative identities result from the child’s inability to develop and maintain a unified sense of self across various discrete behavioral states" (Şar et al, 2017).

https://doi.org/10.1002/da.20874

"For example, DID is currently understood as a complex posttraumatic developmental disorder that usually begins before the age of 5–6.[43,44] It is hypothesized that, after that developmental window, the consolidation of a more unified sense of subjective self and other developmental cognitive changes have occurred. This leads to different kinds of identity disturbances than that of the DID alternate identities in response to overwhelming and/or traumatic circumstances, although other complex dis�sociative symptoms may continue to develop[22]" (Spiegel et al, 2011, p.E20).

The Haunted Self: Structural Dissociation and the Treatment of Chronic Trau... - Google Books

"Tertiary dissociation is much more likely to develop in earlier childhood traumatization (prior to age 8) that is an ongoing part of daily life, so that ANP also becomes structurally dissociated" (van der hart et al., 2006, p.69).

Dissociative Identity Disorder - PMC (nih.gov)

"A retrospective review of that patient’s history typically will reveal onset of dissociative symptoms at ages 5 to 10, with emergence of alters at about the age of 6. Typically by the time they are adults, DID patients report up to 16 alters (adolescents report about 24), but most of these will fade quickly once treatment is begun. There generally is a reported history of childhood abuse, with the frequency of sexual abuse being higher than the frequency of physical abuse." (Gillig, 2009). TheFlowersGrow (talk) 15:29, 17 March 2023 (UTC)

Thank you so much for tackling that clean-up, really appreciate it! Lizthegrey (talk) 17:45, 6 April 2023 (UTC)

No worries. :)

If there's anything else you need help with, let me know. I'm on vacation right now so I have a bit of free time to spare. Cheers! TheFlowersGrow (talk) 15:46, 7 April 2023 (UTC)

This page needs redoing completely

As someone familiar with the research and research community's consensus this page is atrocious. There are numerous factual errors, outdated information, a weird agenda on pushing the the fantasy/sociocognitive model as well as just weird agenda to disprove.

This article makes wikipedia look like a joke. Criticisms or controversies at this point need its own page because the current content is just a mess. It sounds like the presentation of something and then an attempt within the next sentence or paragraph to disprove things.

I could submit all the research evidence of modern conceptions and such, it'd just take a long time and I have a feeling there are a lot of people with an agenda other than documenting current knowledge. Right now this is essay-like, argumentative and often strays right into opinion territory.

This is an article that wikipedia should be ashamed of and I fear there are people with agendas who are maintaining the page. 2601:404:CB00:9E60:B47E:FF73:95EE:5B95 (talk) 23:10, 22 January 2023 (UTC)

Please make concrete suggestions on what you'd like to change. "This is atrocious" is not specific enough for someone to make edits to improve it. Lizthegrey (talk) 00:58, 23 January 2023 (UTC)

I was about to comment something similar to the original point, but I think the main section that needs to be redone is the Society and Culture portion, using an outraged language, at times sardonic and clearly condemning the misrepresentation, I agree that some of the examples are rather egregious in their portrayal but that doesn't mean the Wiki page should also be a condemnation.

There are also some errors spread throughout the previous sections such as improper reference form, syntax errors and lack of proper punctuation for names, such as this example from the Controversy section:

Some people, such as Russell A Powell and Travis L Gee, believe that DID is caused by health care, i.e. symptoms of DID are created by therapists themselves via hypnosis. Ferbabdass (talk) 02:55, 19 April 2023 (UTC)