Reference no: EM133196257

After reading Chapter 10, I have a clearer understanding of dissociative identity disorder (DID). It also reminded me of the current stereotypes of this mental illness in mainstream social thought, especially in film and television productions, where producers often make incorrect depictions of the abilities of people with dissociative disorders in order to create a degree of dramatic effect.

Dissociative identity disorder (DID), also widely referred to as multiple personality disorder, is a mental health condition. In current mainstream literature, DID is often portrayed as having a personality with some degree of violent tendencies, or the mental illness is portrayed as a powerful, cool "ability" that people mistakenly believe that each of the separated personalities has the ability to perform efficiently. Well-known examples include movies and TV shows such as Psycho, Identity, Fight Club, and Moon Knight. In reality, however, people with dissociative disorders, including DID, are no more likely to be dangerous or violent than others.

Another common stereotype is that the personalities of people with dissociative disorders are unable to be aware of each other's presence. When in fact, it would be more often the case that a person with DID may have a alter aware of the host personality, while the host personality is unaware of the alter personality. In this case, the alter personality that arises as a result of the trauma will also usually not have memories of the trauma period. As in Louise's case given at the beginning of Chapter 10, the fact is that many people with DID have difficulty remembering most of their childhood precisely because the mental illness they have is designed to protect them from the effects of childhood trauma. It is forgetting that is usually the protective mechanism for dissociative identity disorder, not that the dissociated personality bears the memories for the other personality.

So I hope that in the future, the mainstream media will stop exploiting stereotypes and reduce the consumption of people with dissociative disorders, and that people will be more accepting an. 

After reading chapter 9, which explains post-traumatic stress disorder (PTSD) and related disorders, it is clear that experiencing sexual or physical assault especially as a child can cause PTSD to occur in an individual. According to criterion A of the DSM-5 an individual must have "been exposed to a traumatic event and either experienced the event directly or vicariously" (p. 325). Being sexually assaulted is clearly a traumatic event, however there are many cases in which individuals who have experienced sexual assault never go on to develop PTSD. Therefore, if a child experienced sexual assault and met only that part of the criteria for PTSD but they experienced no actual symptoms of PTSD like "flashbacks and nightmares of the event" I would not diagnose the child with PTSD (p. 325).

The main reason I would not diagnose the child with PTSD is because according to the DSM-5 an individual has to experience specific symptoms that fall into four different categories for a duration of at least one month. In other words, "trauma is a necessary-but not sufficient-condition in the causal chain of PTSD" (p. 327). Since, in this scenario, the child only experiences a traumatic event and no symptoms or fear of the event are described I would see no reason to go as far as diagnosing this child with PTSD. However, I understand that the child could develop PTSD later in life when they are able to better comprehend what happened to them and they could also be more at risk for developing PTSD in the future after the occurrence of another traumatic event. For example, one psychosocial theory of PTSD states that "two clear factors that suggest strongest risk for PTSD are past trauma history and previous psychiatric history" (p. 331). Therefore, knowing that the child has experienced sexual assault I would make sure to utilize secondary prevention techniques to decrease the chances of them developing PTSD after this event and future traumatic events as well. First, I would make sure that they have a strong social support system. This is because having strong social support has shown to significantly decrease the chances of developing PTSD after a traumatic event. Additionally, I would utilize the four-session prevention course created by Edna Foa to try to decrease the chances of the child thinking of the world as a dangerous place and thinking of themselves as incompetent. This is because if the victim, like the child, begins to view the world as dangerous and themselves as incompetent then they are significantly more likely to eventually develop PTSD because of the traumatic event.

Overall, I would not diagnose a child with PTSD if they experienced sexual assault but no other symptoms of PTSD, especially if they did not experience fear during the traumatic event. However, the event can clearly be categorized as traumatic and could easily lead to PTSD. Therefore, I would use secondary prevention methods to increase the likelihood that the child would not develop PTSD after this event and other traumatic events they may experience throughout their life as well.