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Tijdschrift voor Psychiatrie 38 (1996) 2

New research

Four controversies about dissociative identity disorder

P. Spinhoven

Four controversies about dissociative identity disorder are discussed. First: is this an artefact due to iatrogenic influences? The empirical evidence does not support such a conclusion, although iatrogenic influences may play a considerable part in the presentation of this disorder. Second: how adequate are the present diagnostic criteria? It is argued that the DSM-IV also is eleciting overdiagnosis and that the use of struc- tured clinical interviews should be mandatory. The third controversy concerns the reliability of `recovered memories' and the phenomenon of amnesia. Clinical data and experimental laboratory findings do not converge. Memory research is seriously questioning about the reliability of recovered memories. The massive amnesia for traumatic events, which is clinically reported in dissociative disorders, does not fit well into the data of modern memory research. Finally, it is not yet clear which therapeutic strategy should be considered optimal for these patients, especially as far as trauma revification is concerned.