Multiple personality: Fantasy proneness, demand characteristics, and indirect communication.

An etiology is proposed for multiple personality disorder (MPD) without recourse to dissociated early trauma. MPD may be generated by the interaction of specific cognitive abilities associated with extreme hypnotic susceptibility and fantasy proneness with therapist demand characteristics associated with a belief in the early traumatic origins of MPD. The patient's capacity for segmented, absorbed consciousness; highly uncritical vivid fantasy; and relative secretiveness about fantasy experience matches the therapist's expectations of a mistrustful patient concealing shameful early trauma in colorful dissociated reenactments. The necessity to earn trust pulls for credulity; the expectation of concealment pulls for probing suggestive therapeutic techniques. Dramatic representation of apparent early abuse is conceptualized as an indirect commentary on the patient's current therapeutic experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple personality disorder: scientific and medicolegal issues

Despite the intense study it has received since its inclusion in DSM-III, multiple personality disorder (MPD) largely remains an unvalidated construct. Definitional problems remain (there is not even agreement in the field as to whether a diagnosis of MPD truly means the existence of more than one personality), while the vagueness and liberality of existing criteria give the clinician little guidance in diagnosis. In forensic settings, diagnosis of MPD is even more problematic, since there is substantial evidence that the disorder cannot currently be phenomenologically distinguished from malingering. It also remains to be demonstrated that evaluators can determine whether alter personalities, if they exist, are truly unaware of each other, lack control over other alters' behavior, or are unable to know right from wrong.     

Multiple personality disorder: Etiology, treatment, and treatment techniques from a psychodynamic perspective.

Academic psychologists have moved away from psychoanalytic and psychodynamic explanations of human functioning and pathology and have instead embraced neuropsychology and cognitive science. This trend has kept many psychologists and researchers from more fully understanding some of the important phenomena they chose to investigate. One area about which psychologists can learn in the psychodynamic literature is multiple personality disorder (MPD). A thorough knowledge of the psychodynamic perspective with regards to MPD is important to all those in psychology who deal with MPD patients or who study the phenomenon. By understanding the abuse most of these patients suffered and the resulting impact this has had on their personality development, psychologists can begin to create effective and promising assessment tools and intervention programs. In this article, I review MPD and its treatment from a psychodynamic perspective in hopes that those in psychology (researchers and clinicians alike) may benefit from such a discussion and will utilize this information in their attempts to understand MPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does the mind fall apart in multiple personality disorder? Some proposals based on a psychoanalytic case

A psychoanalytic study of some of the phenomena of multiple personality disorder (MPD), this paper takes issue with the view that a falling apart, fragmentation, or disaggregation of the mind is at the bottom of MPD's characteristic symptoms. Since first proposed by Janet in 1889, the view that ordinarily integrated parts of the mind separate from the center, accounting for the appearance of separate "selves," has prevailed among workers in this field. The close psychoanalytic study of a case of MPD suggests that, to the contrary, the appearance of multiplicity may derive from an essentially unitary but nonetheless powerful set of organizing fantasies centering on the idea that one's body and mind can be taken over and controlled by persons other than oneself. The data of the case under study suggest, further, that certain of the details of these patients' histories of childhood sexual and physical abuse may be of great importance in explaining the extraordinary organizing power of their fantasies of being occupied and controlled. In this connection, special attention is directed to the very commonly reported experiences of forced violation and the involuntary filling and emptying of their bodies during childhood.     

Confirmation of childhood abuse in child and adolescent cases of multiple personality disorder and dissociative disorder not otherwise specified

The diagnostic validity of multiple personality disorder (MPD) and its association to trauma have been questioned because corroboration of child abuse in studies of patients with MPD is scant. The purpose of this study was to determine on a retrospective basis whether external corroboration of child abuse could be found in a group of patients with MPD and dissociative disorder not otherwise specified. A group of child and adolescent psychiatric inpatients and outpatients was chosen because of the extensive number of collateral records collected on them in a tertiary care setting. This group was also chosen because of the intense interest paid by child protective services and courts to child abuse during the past 15 years. This retrospective chart review confirmed child abuse in eight of nine patients with MPD and in all 12 cases of dissociative disorder not otherwise specified. This study provides further evidence of the association of severe dissociative disorders with trauma, particularly child abuse. Future studies should be prospective and blinded to avoid the possibility of investigator bias, and should include a control group for comparison of base rate of child abuse.     

Professional skepticism of multiple personality disorder.

If you saw a patient who appeared to have more than one personality, what diagnosis would you make? And how would you vary your clinical approach? Data from 425 respondents indicated that the majority of psychologists believed multiple personality disorder (MPD) to be a valid but rare clinical diagnosis. Respondents cited extreme child abuse as the foremost cause of MPD. Approximately one-half of all respondents believed that they had encountered a client with MPD, whereas less than one-third believed that they had encountered a client who feigned MPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multiple personality disorder manifesting itself under the mask of transsexualism

The case of a young female patient is described who presented symptoms of transsexualism; surgical intervention was considered. Admitted to the hospital after having become depressed and suicidal, a thorough examination and observation revealed the presence of multiple personality disorder (MPD). Even though transsexualism and MPD represent two different conditions, there are many similarities between them. The possibility of MPD should be considered in every case of transsexualism.     

The rational treatment of multiple personality disorder.

The complex symptomatology of patients who have survived profound childhood abuse, particularly the severe dissociative and posttraumatic symptoms of patients with multiple personality disorder (MPD), may predispose therapists to engage in poorly considered psychotherapeutic practices. Therapists should be careful to keep a rational clinical perspective and not to be distracted by patients' unusual and dramatic clinical presentation. This article discusses the particular problematic areas often encountered in the treatment of MPD patients, including the necessity for pacing the therapy, keeping the focus on the patient as a whole, and avoiding preoccupation with individual personalities or with MPD phenomenology. Clinical vignettes illustrate these areas of difficulty. Good clinical judgment and sound therapeutic principles permit rational and productive treatment even for challenging MPD patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From dissociation to negotiation: A relational psychoanalytic perspective on multiple personality disorder.

Presents a model for conceptualizing the dynamics and treatment of multiple personality disorder (MPD) that integrates trauma/dissociation theories with postclassical psychoanalytic perspectives. MPD is conceptualized as a chronic trauma syndrome and as a particular variation of narcissistic personality organization involving an overreliance on omnipotent defenses, the collapse of intersubjective experiencing, and derailments of the developmental lines of aggression, fantasy, and the use of transitional phenomena. Emphasis on empathy, recognition, confrontation, and interpretation from within the transference-countertransference matrix is recommended to facilitate contactful dialog and negotiation in the interpersonal world and between traumatically dissociated, often opposing, aspects of the self. The MPD patient's capacities for mutuality, paradoxical experiencing, and restorative fantasy are seen as central to integration. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

An outbreak of Salmonella enteritidis in a maternity and neonatal intensive care unit

We investigated the relationships between methylphenidate (MPD) enantiomers and endogenous dopamine (DA) levels in striatal extracellular fluid, and that between DA level and locomotor activity, after intravenous administration of racemic MPD (2, 5 or 10 mg/kg dose) or the individual enantiomers (2.5 mg/kg dose) to rats. MPD and DA levels in the extracellular fluid were measured by in vivo brain microdialysis. The maximum levels of MPD enantiomers in the striatal extracellular fluid were obtained within 15 min after administration. On the other hand, the mean maximum DA levels after administration of 2-10 mg/kg dose of racemic MPD were obtained within 10 min with values in the range of 3.0- to 8.6-fold higher than the basal DA level. The maximum DA level (4.2-fold of the basal level) after administration of (+/-)-MPD was greater than that (2.2-fold) of the same dose of (-)-MPD. A clockwise hysteresis was observed between MPD concentration and DA level in the extracellular fluid after MPD administration. Locomotor activity after administration of (+)-MPD was also greater than (-)-MPD. From these results, it was shown that the locomotor activity induced by MPD may be related to the increase of DA level in the extracellular fluid, and the degree of increase of the DA level by (+)-MPD was greater than that of the (-)-isomer.     

Chronic pancreatitis, acute pancreatitis

MRCP has been recognized as a safe and noninvasive diagnostic method. In the present study we evaluated the usefulness of MRCP in diagnosis of chronic and acute pancreatitis. Two-dimensional fast asymmetric spin-echo (FASE) MRCP was performed in 40 patients with chronic pancreatitis and 13 with acute pancreatitis. In 29 patients (72.5%) with chronic pancreatitis and 9 (66.7%) with acute pancreatitis, main pancreatic duct (MPD) was visualized entirely. MRCP could demonstrate the characteristic findings of chronic pancreatitis such as dilatation and irregularity of MPD in most cases. In acute pancreatitis, MRCP indicated that MPD was normal in diameter, but irregular in configuration compared with that of the control group. MRCP may facilitate the diagnosis of chronic and acute pancreatitis.     

Mental health professionals' skepticism about multiple personality disorder.

Three studies were conducted to investigate the nature of mental health professionals' skepticism regarding multiple personality disorder (MPD). An initial pilot study was conducted to develop a psychometrically sound survey instrument. In Study 2, the results of a national survey of 207 mental health professionals supported the hypothesis that skepticism and knowledge about MPD are inversely related, r?=?–.33, p?     

不同的多点成形工艺方式对回弹的影响

采用有限元数值模拟手段针对多点成形过程中产生的回弹现象进行了探讨．主要对比了多点模具成形和多点压机成形两种不同工艺,分析了不同的工艺条件对回弹的影响．采用先显式方法计算成形,后隐式方法计算回弹,对1mm与2mm厚度的球形曲面件进行了数值模拟．结果表明：在冲头为10×10的多点模具成形方式下,采用无压边成形,成形1mm厚度的板料时,曲率半径为400mm的成形件回弹量沿纵向最大为1．22mm;但在相同条件下,用多点压机成形工艺的成形件,回弹量仅为0．24mm,即一次成形时,多点压机成形的板料比多点模具成形的板料回弹量仅为1/5;多点压机成形厚度为2mm的板料回弹约为0．多点压机成形方式比多点模具成形方式成形效果好,回弹量明显减小．     

Consequences of organizational justice expectations in a selection system.

This study examined several consequences of applicants' expectations of organizational justice at multiple stages in a selection process. The authors assessed the justice expectations of 1,832 job applicants prior to their participation in a testing process and examined how these expectations influenced their pretest attitudes and intentions as well as their perceptions of the testing process. Results revealed that applicants with higher expectations of justice reported higher levels of pretest motivation and more positive job acceptance and recommendation intentions. Justice expectations were also positively related to applicants' perceptions of justice in the testing process. Results provided some evidence that justice expectations have a moderating influence, such that justice perceptions have a greater influence on applicants' affective and cognitive states when expectations of justice are high. The theoretical and practical implications of these findings are discussed in the context of research on organizational justice and applicant perceptions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Autobiographical memory in a case of multiple personality disorder.

Previous research on multiple personality disorder (MPD) has been concerned with between-personalities amnesia, and little attention has been paid to within-personality memory function. This study examined the autobiographical memory of a multiple personality patient, I.C., with cuing procedures that have proven useful in previous studies of normal and abnormal memory. Results indicated that I.C. was able to retrieve autobiographical episodes from the recent past, although her performance differed in several respects from that of matched controls. The study also revealed a striking deficit in I.C.'s autobiographical memory for childhood: She was unable to recall a single episode from prior to the age of 10 in response to various retrieval cues, whereas control subjects had no difficulty recalling numerous childhood episodes. This phenomenon of extended childhood amnesia has not been reported previously in studies of MPD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Masseter muscle hyperactivity and myofascial pain dysfunction syndrome: a relationship under stress

Myofascial pain dysfunction syndrome (MPD) of the temporomandibular joint (TMJ) is a psychophysiological disorder that develops because of hyperactive muscles of mastication. Ten women meeting criteria for MPD and 12 symptom-free women participated in the study. The rationale for this study was to observe cardiovascular and masseter muscle changes during four contiguous experimental periods: baseline/adaptation, reaction time, recovery, and relaxation. MPD patients showed less masseter muscle activity and higher heart rates at baseline than controls. Controls had significantly higher masseter EMG activity during reaction time. Both groups showed significant elevation in masseter muscle activity and heart rate over the 14-min reaction period. MPD patients' recovery from stress was equivalent to controls' for both heart rate and masseter muscle activity. MPD patients exhibited significantly slower reaction times than controls. The results suggest that masseter muscle hyperactivity may not account for the development and maintenance of MPD.     

Does Poor Vagal Tone Exacerbate Child Maladjustment in the Context of Parental Problem Drinking? A Longitudinal Examination.

Children's vagal tone was examined as a vulnerability factor in the longitudinal relation between mothers' (MPD) and fathers' (FPD) problem drinking and children's adjustment. At T1, MPD and FPD were examined, and children's vagal tone was assessed. Two years following initial participation, child adjustment problems were evaluated. A lower level of vagal tone was a vulnerability factor for internalizing problems associated with MPD and FPD and for externalizing difficulties associated with MPD. In the context of a higher level of MPD or FPD, a lower level of vagal tone was a vulnerability factor for increases in externalizing problems over time. Results are supportive of the importance of biopsychosocial perspectives in which child characteristics interact with family risk to predict psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-efficacy and perceived control: Cognitive mediators of pain tolerance.

The cold-pressor task was used with 102 female undergraduates in 2 experiments to determine (a) whether self-efficacy has validity as a true causal determinant of behavior change or is a correlate of change that has already occurred and (b) how perceptions of control and self-efficacy interact to determine choice behavior, persistence, and the impact of an aversive stimulus. Results of Experiment 1 indicate that self-efficacy expectations affected performance beyond what would have been expected from past performance alone. Changes in self-efficacy expectations predicted changes in cold-pressor tolerance. These findings suggest that self-efficacy expectations can be causal determinants of behavior in an aversive situation. Results of Experiment 2 indicate that self-efficacy was separable from control and that performance was best if both high levels of perceived control and self-efficacy were present. These findings support the notion that self-efficacy expectations can mediate the desirability of providing control, in that those who benefit most from control are those who are most confident they can exercise it. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rethinking the comparison of borderline personality disorder and multiple personality disorder

This article has made a number of points that assert what is today a minority position within the fields of MPD/DID and BPD. We hope our views will stimulate attempts by others to rethink their positions and test our assertions, so that issues surrounding these two disorders can be sharpened. For the sake of the clarity of future work, we summarize in outline form the essence of our viewpoint. 1. BPD and MPD/DID have similar appearing symptoms, such as identity problems, unstable affect modulation, self-destructive behaviors, chaotic impulse control, and troubled interpersonal relationships, but they have decisive differences in underlying dynamics, process, and structure. 2. DSM tends to blur these two disorders by its emphasis on phenomenology over inner structure, thus fostering misleading conclusions when DSM criteria are used to test for comorbidity or overlap between BPD and MPD/DID. 3. BPD and MPD/DID are both described dynamically as using the defense of splitting, but we contend that the splitting in each disorder is fundamentally different from the splitting in the other. BPD uses a polarization form of splitting, whereas MPD/DID uses ego splitting or identity division. 4. Both disorders partake in the process of dissociation, but the quality of dissociation in BPD is a "low-tech" spaced out type, whereas that of MPD/DID is a "high-tech" waking dream. 5. BPD structure is also "low tech," with polarization of self, object, and relationship. MPD/DID structure is "high tech," with heavily symbolic, highly nuanced variations of self, object, and relationship. 6. Although both conditions have etiologic elements of trauma, BPD has a larger degree of developmental deficiency, with a failure to complete the task of entering a repression hierarchy of defenses. MPD/DID, by use of primary process-linked symbolic dissociation, is able to continue development to the repression hierarchy, although at a profound cost of simultaneous suspension of reality testing. BPD patients suffer from the rigid use of too few defenses; MPD/DID patients suffer from the obsolete use of too many defenses. 7. BPD patients grow up in homes in which overtly expressed aggression is more tolerated, or at least more openly experienced. MPD/DID patients grow up in homes in which the fact of aggression is kept a secret. This has consequences for the formation of psychic structure in each disorder.(ABSTRACT TRUNCATED AT 400 WORDS)