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Can children develop dissociative identity disorder ? Theoretical exploration of the origins of the fragmented self

1 January 1998


This dissertation explores the origins and nature of Dissociative Identity Disorder (DID). The validity of the diagnosis of DID is discussed, and then the question of whether or not children can develop this disorder is examined in depth. To facilitate this examination, etiological factors are probed, including the link between childhood abuse, trauma, and dissociation. Cultural influences on what is traumatic to individuals are explored, as is the chronic and intense nature of abuse and trauma reported by individuals diagnosed with DID. Childhood and adulthood forms of this disorder are discussed and compared, and it is suggested that the childhood form (Childhood Dissociative Identity Disorder--CDID) is distinct from the adult form (Adult Dissociative Identity Disorder--ADID), and merits its own diagnostic category. Possible reasons for the underdiagnosis of DID in children are explored. It is argued that due to the more subtle, internal nature of CDID, it may frequently be mistaken for other, more common, childhood disorders, such as depression, conduct disorder, or attention-deficit-hyperactivity disorder. Current developmental models for
formation of DID are studied, and a new developmental theory called the Disrupted Self Model of Dissociative Identity Disorder is presented. This model builds upon aspects of prior models, while including overlooked research on infants' behavioral states, attachment, and development of a sense of self. It is argued that the foundation of CDID is a problematic caregiver-infant relationship
in which the caregiver is not able to successfully soothe the child and regulate his or her behavioral states. This relational dysfunction results in a fragmented sense of self that then sets the stage for development of CDID. Throughout this dissertation, background and examples are offered from a clinical case to provide illustration of themes and concepts raised.


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