Gender identity and autism spectrum disorders.

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van Schalkwyk, Gerrit I; Klingensmith, Katherine; Volkmar, Fred R

2015-03-01

In this review, we briefly summarize much of the existing literature on gender-related concerns and autism spectrum disorders (ASD), drawing attention to critical shortcomings in our current understanding and potential clinical implications. Some authors have concluded that gender identity disorder (GID), or gender dysphoria (GD), is more common in individuals with ASD, providing a range of potential explanations. However, existing literature is quantitatively limited, and our capacity to draw conclusions is further complicated by conceptual challenges regarding how gender identity is best understood. Discourses that emphasize gender as a component of identity formation are gaining prominence and seem particularly salient when applied to ASD. Individuals with ASD should enjoy equal rights with regard to treatment for gender dysphoria. Clinicians may be able to assist individuals in understanding this aspect of their identity by broadening the social frame and facilitating an exploration of gender roles.

Gender identity disorder and schizophrenia: neurodevelopmental disorders with common causal mechanisms?

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Rajkumar, Ravi Philip

2014-01-01

Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor (BDNF), early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed.

Gender Identity Disorder and Schizophrenia: Neurodevelopmental Disorders with Common Causal Mechanisms?

Directory of Open Access Journals (Sweden)

Ravi Philip Rajkumar

2014-01-01

Full Text Available Gender identity disorder (GID, recently renamed gender dysphoria (GD, is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor (BDNF, early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed.

Body Integrity Identity Disorder

NARCIS (Netherlands)

Blom, Rianne M.; Hennekam, Raoul C.; Denys, Damiaan

2012-01-01

Introduction: Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal

Body integrity identity disorder.

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Blom, Rianne M; Hennekam, Raoul C; Denys, Damiaan

2012-01-01

Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID. Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation) were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared. Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification. The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

Body integrity identity disorder.

Directory of Open Access Journals (Sweden)

Rianne M Blom

Full Text Available INTRODUCTION: Body Integrity Identity Disorder (BIID is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID. METHODS: Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared. RESULTS: Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification. CONCLUSIONS: The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

[Dissociative identity disorder or schizophrenia?].

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Tschöke, S; Steinert, T

2010-01-01

We present a case of dissociative identity disorder in which Schneiderian first rank symptoms were present besides of various states of consciousness. Thus the diagnosis of schizophrenia had to be considered. Formally, the symptoms met ICD-10 criteria for schizophrenia. However, taking into account the lack of formal thought disorder and of negative symptoms as well as a typical history of severe and prolonged traumatisation, we did not diagnose a co-morbid schizophrenic disorder. There is good evidence for the existence of psychotic symptoms among patients with dissociative disorders. However, in clinical practice this differential diagnosis is rarely considered.

Amputatiewens bij 'body integrity identity disorder'

NARCIS (Netherlands)

Blom, Rianne M.; Hennekam, Raoul C. M.

2014-01-01

Body integrity identity disorder (BIID) is a rare neuropsychiatric disorder in which patients experience a mismatch between the real and experienced body from childhood. BIID results in a strong desire to amputate or paralyse one or more limbs. We describe two BIID patients. A 40-year-old healthy

Associations between identity diffusion, Axis II disorder, and psychopathology in inpatients with borderline personality disorder.

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Sollberger, Daniel; Gremaud-Heitz, Daniela; Riemenschneider, Anke; Küchenhoff, Joachim; Dammann, Gerhard; Walter, Marc

2012-01-01

Patients with borderline personality disorder (BPD) suffer from instability in their relationships, their affectivity, and their identity. However, the associations between these dimensions are not clear. The purpose of the present study was to investigate the relation between identity diffusion and psychopathology in BPD. In the second week of inpatient treatment, 52 patients with BPD were assessed with the Inventory of Personality Organization (IPO) and questionnaires measuring general psychiatric symptoms, mood states, and negative affects (SCL-90-R, BDI, STAI, and STAXI). A median split was examined to differentiate BPD patients with high identity diffusion from those with low identity diffusion. BPD patients with high identity diffusion did not differ in their social data from BPD patients with low identity diffusion. However, BPD patients with high identity diffusion showed significantly higher levels of psychiatric symptoms, as well as higher anxiety, anger, and depression scores (p personality disorders (p identity diffusion with psychopathological symptoms and features of personality disorder and emphasize the clinical significance of identity diffusion for patients with BPD. Copyright © 2011 S. Karger AG, Basel.

Psychiatric comorbidity of gender identity disorders: a survey among Dutch psychiatrists.

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à Campo, Joost; Nijman, Henk; Merckelbach, H; Evers, Catharine

2003-07-01

In the Netherlands, it is considered good medical practice to offer patients with gender identity disorder the option to undergo hormonal and surgical sex reassignment therapy. A liberalization of treatment guidelines now allows for such treatment to be started at puberty or prepuberty. The question arises as to what extent gender identity disorder can be reliably distinguished from a cross-gender identification that is secondary to other psychiatric disorders. The authors sent survey questionnaires to 382 board-certified Dutch psychiatrists regarding their experiences with diagnosing and treating patients with gender identity disorder. One hundred eighty-six psychiatrists responded to the survey. These respondents reported on 584 patients with cross-gender identification. In 225 patients (39%), gender identity disorder was regarded as the primary diagnosis. For the remaining 359 patients (61%), cross-gender identification was comorbid with other psychiatric disorders. In 270 (75%) of these 359 patients, cross-gender identification was interpreted as an epiphenomenon of other psychiatric illnesses, notably personality, mood, dissociative, and psychotic disorders. These data suggest that there is little consensus, at least among Dutch psychiatrists, about diagnostic features of gender identity disorder or about the minimum age at which sex reassignment therapy is a safe option. Therapy options proposed to patients with gender identity disorder appear to depend on personal preferences of psychiatrists. These results underline the need for more specific diagnostic rules in this area.

Errors of Logic and Scholarship Concerning Dissociative Identity Disorder

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Ross, Colin A.

2009-01-01

The author reviewed a two-part critique of dissociative identity disorder published in the "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…

Childhood Gender Identity...Disorder? Developmental, Cultural, and Diagnostic Concerns

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Dragowski, Eliza A.; Scharron-del Rio, Maria R.; Sandigorsky, Amy L.

2011-01-01

Childhood gender identity development is reviewed in the context of biological, environmental, cultural, and diagnostic factors. With the upcoming 5th revision of the "Diagnostic and Statistical Manual of Mental Disorders," the authors offer a critical consideration of childhood gender identity disorder, along with proposed diagnostic changes.…

[The history of the concept of gender identity disorder].

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Koh, Jun

2012-01-01

The Metamorphoses Greek myth includes a story about a woman raised as a male falling in love with another woman, and being transformed into a man prior to a wedding ceremony and staying with her. It is therefore considered that people who desire to live as though they have the opposite gender have existed since ancient times. People who express a sense of discomfort with their anatomical sex and related roles have been reported in the medical literature since the middle of the 19th century. However, homosexual, fetishism, gender identity disorder, and associated conditions were mixed together and regarded as types of sexual perversion that were considered ethically objectionable until the 1950s. The first performance of sex-reassignment surgery in 1952 attracted considerable attention, and the sexologist Harry Benjamin reported a case of 'a woman kept in the body of a man', which was called transsexualism. John William Money studied the sexual consciousness about disorders of sex development and advocated the concept of gender in 1957. Thereafter the disparity between anatomical sex and gender identity was referred to as the psychopathological condition of gender identity disorder, and this was used for its diagnostic name when it was introduced into DSM-III in 1980. However, gender identity disorder encompasses a spectrum of conditions, and DSM-III -R categorized it into three types: transsexualism, nontranssexualism, and not otherwise specified. The first two types were subsequently combined and standardized into the official diagnostic name of 'gender identity disorder' in DSM-IV. In contrast, gender identity disorder was categorized into four groups (including transsexualism and dual-role transvestism) in ICD-10. A draft proposal of DSM-5 has been submitted, in which the diagnostic name of gender identity disorder has been changed to gender dysphoria. Also, it refers to 'assigned gender' rather than to 'sex', and includes disorders of sexual development

Eating Disorder Symptomatology and Identity Formation in Adolescence: A Cross-Lagged Longitudinal Approach.

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Verschueren, Margaux; Claes, Laurence; Bogaerts, Annabel; Palmeroni, Nina; Gandhi, Amarendra; Moons, Philip; Luyckx, Koen

2018-01-01

Introduction: Eating disorder symptomatology, comprising both psychological and behavioral aspects of subclinical eating concerns, constitutes a clear precursor of developing eating disorders. It is crucial to investigate its antecedents and correlates to subsequently inform eating disorder prevention programs. The present study focused on identity formation, a core developmental task in adolescence, that has increasingly been linked to eating disorder development. Our main aim was to examine the temporal sequence between eating disorder symptomatology and identity formation. Methods: Data on eating disorder symptomatology and identity formation were collected in 530 high school students (at Time 1: mean age = 15 years; SD = 1.84; range: 12-18 years; 50.6% females) using self-report questionnaires at three annual measurement points. Cross-lagged structural equation modeling was performed to examine the directionality of effects. Results: Results indicated bidirectional effects between eating disorder symptomatology and identity formation. Identity confusion seemed to increase vulnerability to body dissatisfaction and bulimia symptoms, whereas identity synthesis seemed to protect against their development. Additionally, identity synthesis seemed to protect against the development of drive for thinness as well. At the same time, body dissatisfaction and bulimia symptoms positively predicted identity confusion and negatively predicted identity synthesis over time. Conclusion: The present study adds to the growing body of literature on identity and eating disorders by focusing on their temporal interplay in a community sample of adolescents. As bidirectional effects emerged, a greater emphasis on identity formation in eating disorder prevention programs is advocated.

Dissociative Identity Disorders in Korea: Two Recent Cases.

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Kim, Ilbin; Kim, Daeho; Jung, Hyun-Jin

2016-03-01

Although dissociative identity disorder (DID), the most severe of the dissociative disorders, has retained its own diagnostic entity since its introduction in the DSM-III, cases of DID are rarely seen in South and East Asia, likely due to the higher prevalence of possession disorder. We report two patients with DID who were recently admitted to our inpatient psychiatric unit and demonstrated distinct transitions to several identities. Their diagnoses were confirmed through a structured interview for dissociative disorders and possible differential diagnoses were ruled out by psychological, neuroimaging, and laboratory tests. The rapid transition to a Westernized, individualized society along with an increase in child abuse, might contribute to an increase in DID, previously under-diagnosed in this region.

Gender Identity Disorder and Schizophrenia: Neurodevelopmental Disorders with Common Causal Mechanisms?

OpenAIRE

Ravi Philip Rajkumar

2014-01-01

Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological res...

Eating Disorder Symptomatology and Identity Formation in Adolescence: A Cross-Lagged Longitudinal Approach

Directory of Open Access Journals (Sweden)

Margaux Verschueren

2018-06-01

Full Text Available Introduction: Eating disorder symptomatology, comprising both psychological and behavioral aspects of subclinical eating concerns, constitutes a clear precursor of developing eating disorders. It is crucial to investigate its antecedents and correlates to subsequently inform eating disorder prevention programs. The present study focused on identity formation, a core developmental task in adolescence, that has increasingly been linked to eating disorder development. Our main aim was to examine the temporal sequence between eating disorder symptomatology and identity formation.Methods: Data on eating disorder symptomatology and identity formation were collected in 530 high school students (at Time 1: mean age = 15 years; SD = 1.84; range: 12–18 years; 50.6% females using self-report questionnaires at three annual measurement points. Cross-lagged structural equation modeling was performed to examine the directionality of effects.Results: Results indicated bidirectional effects between eating disorder symptomatology and identity formation. Identity confusion seemed to increase vulnerability to body dissatisfaction and bulimia symptoms, whereas identity synthesis seemed to protect against their development. Additionally, identity synthesis seemed to protect against the development of drive for thinness as well. At the same time, body dissatisfaction and bulimia symptoms positively predicted identity confusion and negatively predicted identity synthesis over time.Conclusion: The present study adds to the growing body of literature on identity and eating disorders by focusing on their temporal interplay in a community sample of adolescents. As bidirectional effects emerged, a greater emphasis on identity formation in eating disorder prevention programs is advocated.

Mirror Writing and a Dissociative Identity Disorder

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Catherine Le

2009-01-01

Full Text Available Individuals with dissociative identity disorder (DID have been known to show varied skills and talents as they change from one dissociative state to another. For example, case reports have described people who have changed their handedness or have spoken foreign languages during their dissociative states. During an interview with a patient with DID, a surprising talent emerged when she wrote a sentence for the Folstein Mini-Mental State Exam—mirror writing. It is not known whether her mirror writing had a deeper level of meaning; however, it does emphasize the idiosyncratic nature of dissociative identity disorder.

Mirror writing and a dissociative identity disorder.

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Le, Catherine; Smith, Joyce; Cohen, Lewis

2009-01-01

Individuals with dissociative identity disorder (DID) have been known to show varied skills and talents as they change from one dissociative state to another. For example, case reports have described people who have changed their handedness or have spoken foreign languages during their dissociative states. During an interview with a patient with DID, a surprising talent emerged when she wrote a sentence for the Folstein Mini-Mental State Exam-mirror writing. It is not known whether her mirror writing had a deeper level of meaning; however, it does emphasize the idiosyncratic nature of dissociative identity disorder.

Awareness of identity alteration and diagnostic preference between borderline personality disorder and dissociative disorders.

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Sar, Vedat; Alioğlu, Firdevs; Akyuz, Gamze; Tayakısı, Emre; Öğülmüş, Ezgi F; Sönmez, Doğuş

2017-01-01

This study inquires into identity alteration among college students and its relationship to borderline personality disorder (BPD) and/or dissociative disorders (DDs). Steinberg Identity Alteration Questionnaire (SIAQ), Childhood Trauma Questionnaire (CTQ), and self-report screening tool of the BPD section of the Structured Clinical Interview for DSM-IV (SCID-BPD) were administered to 1301 college students. Participants who fit the diagnostic criteria of BPD (n = 80) according to the clinician-administered SCID-BPD and 111 non-BPD controls were evaluated using the Structured Clinical Interview for DSM-IV DDs (SCID-D) by two psychiatrists blind to the group membership and scale scores. Test-retest evaluations and internal consistency analyses suggested that SIAQ was a reliable instrument. Of the participants, 11.3% reported a SIAQ score 25 or above alongside some impairment. SIAQ scores differentiated participants who fit the diagnostic criteria for a DD from those who did not. While self-report identity alteration was correlated with all childhood trauma types, clinician-assessed identity alteration was correlated with childhood sexual abuse only. Those who fit criteria for both disorders had the highest identity alteration scores in self-report and clinician-assessment. Although both syndromes had significant effect on self-report identity alteration total scores, in contrast to DD, BPD did not have an effect on the clinician-administered evaluation. An impression of personality disorder rather than a DD may seem more likely when identity alteration remains subtle in clinical assessment, notwithstanding its presence in self-report. Lack of recognition of identity alteration may lead to overdiagnosis of BPD among individuals who have a DD.

Autobiographical memory specificity in dissociative identity disorder.

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Huntjens, Rafaële J C; Wessel, Ineke; Hermans, Dirk; van Minnen, Agnes

2014-05-01

A lack of adequate access to autobiographical knowledge has been related to psychopathology. More specifically, patients suffering from depression or a history of trauma have been found to be characterized by overgeneral memory, in other words, they show a relative difficulty in retrieving a specific event from memory located in time and place. Previous studies of overgeneral memory have not included patients with dissociative disorders. These patients are interesting to consider, as they are hypothesized to have the ability to selectively compartmentalize information linked to negative emotions. This study examined avoidance and overgeneral memory in patients with dissociative identity disorder (DID; n = 12). The patients completed the autobiographical memory test (AMT). Their performance was compared with control groups of posttraumatic stress disorder (PTSD) patients (n = 26), healthy controls (n = 29), and DID simulators (n = 26). Specifically, we compared the performance of separate identity states in DID hypothesized to diverge in the use of avoidance as a coping strategy to deal with negative affect. No significant differences in memory specificity were found between the separate identities in DID. Irrespective of identity state, DID patients were characterized by a lack of memory specificity, which was similar to the lack of memory specificity found in PTSD patients. The converging results for DID and PTSD patients add empirical evidence for the role of overgeneral memory involved in the maintenance of posttraumatic psychopathology.

Parent-child relationships in gender identity disorder.

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Church, H A; O'Shea, D; Lucey, J V

2014-06-01

To describe the relationship between parents with gender identity disorder (GID) and their child(ren) as described by the parent and to understand how being a parent affects transitioning from one gender to the other. Fourteen parents with GID underwent a semi-structured interview and completed the Index of Parental Attitudes (IPA). An IPA score of greater than 30 indicates parent–child relationship difficulties (range 0–100). The authors also conducted the SCID-I to establish other Axis I disorders. We assessed 12 male to female and two female to male parents with GID residing in Ireland. In total, 14 GID parents had 28 children. Three children had no relationship with their GID parent. The other 25 children, as reported by the parent, had good relationships with their children. In addition, these 25 children average score IPA score was 6.4 (range 0–25). Twelve GID parents (86 %) believed that being a parent had no effect on their desired level of transitioning, while two were influenced not to transition. Eleven GID parents (79 %) reported that being a parent had increased the time taken to commence transitioning, two have stopped transitioning altogether, while one cited no effect on time. Parents with GID report positive relationships or no relationship with their children and the IPA revealed no clinical problems. Being a parent can prolong transitioning time in people with GID and can affect overall achieved level of transitioning.

Memory transfer for emotionally valenced words between identities in dissociative identity disorder.

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Huntjens, Rafaële J C; Peters, Madelon L; Woertman, Liesbeth; van der Hart, Onno; Postma, Albert

2007-04-01

The present study aimed to determine interidentity retrieval of emotionally valenced words in dissociative identity disorder (DID). Twenty-two DID patients participated together with 25 normal controls and 25 controls instructed to simulate DID. Two wordlists A and B were constructed including neutral, positive and negative material. List A was shown to one identity, while list B was shown to another identity claiming total amnesia for the words learned by the first identity. The identity claiming amnesia was tested for intrusions from list A words into the recall of words from list B and recognition of the words learned by both identities. Test results indicated no evidence of total interidentity amnesia for emotionally valenced material in DID. It is argued that dissociative amnesia in DID may more adequately be described as a disturbance in meta-memory functioning instead of an actual retrieval inability.

A study of changes in bone metabolism in cases of gender identity disorder.

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Miyajima, Tsuyoshi; Kim, Yoon Taek; Oda, Hiromi

2012-07-01

The aim of this study was to determine the effect of increasing estrogen and decreasing androgen in males and increasing androgen and decreasing estrogen in females on bone metabolism in patients with gender identity disorder (GID). We measured and examined bone mineral density (BMD) and bone metabolism markers retrospectively in GID patients who were treated in our hospital. In addition, we studied the effects of treatment on those who had osteoporosis. Patients who underwent a change from male to female (MtF) showed inhibition of bone resorption and increased L2-4 BMD whereas those who underwent a change from female to male (FtM) had increased bone resorption and decreased L2-4 BMD. Six months after administration of risedronate to FtM patients with osteoporosis, L2-4 BMD increased and bone resorption markers decreased. These results indicate that estrogen is an important element with regard to bone metabolism in males.

Features of the differential diagnosis of persons with gender identity disorders

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Z.D. Novikova

2013-10-01

Full Text Available We presented a study of the features of gender identity in people undergoing gender, psychological and psychiatric examination to address the issue of gender reassignment. We analyze the specifics of gender identity, levels of masculinity and femininity, the similarities and differentiation within four nosological groups, which include persons with gender identity disorders (GID with transsexualism, personality disorders, diseases of the schizophrenia spectrum, and with organic mental disorders. We address the question of the differential diagnosis in the process of psychological screening of people with transsexualism and other types of GID. The analytical description of the four algorithms and their comparison are psychologically specific, qualitative research, almost impossible using statistical method of data processing. The data presented may be useful to specialists involved in the study of persons with gender identity disorders

Gender identity and sexual orientation in autism spectrum disorder.

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George, Rita; Stokes, Mark A

2017-09-01

Clinical impressions indicate that there is an overrepresentation of gender-dysphoria within the autism spectrum disorder. However, little is presently known about the demographics of gender-identity issues in autism spectrum disorder. Based upon what little is known, we hypothesized that there would be an increased prevalence of gender-dysphoria among those with autism spectrum disorder compared to a typically developing population. We surveyed gender-dysphoria with the Gender-Identity/Gender-Dysphoria Questionnaire among 90 males and 219 females with autism spectrum disorder and compared these rates to those of 103 males and 158 females without autism spectrum disorder. When compared to typically developing individuals, autistic individuals reported a higher number of gender-dysphoric traits. Rates of gender-dysphoria in the group with autism spectrum disorder were significantly higher than reported in the wider population. Mediation analysis found that the relationship between autistic traits and sexual orientation was mediated by gender-dysphoric traits. Results suggest that autism spectrum disorder presents a unique experience to the formation and consolidation of gender identity, and for some autistic individuals, their sexual orientation relates to their gender experience. It is important that clinicians working with autism spectrum disorder are aware of the gender-diversity in this population so that the necessary support for healthy socio-sexual functioning and mental well-being is provided.

An archetype of the collaborative efforts of psychotherapy and psychopharmacology in successfully treating dissociative identity disorder with comorbid bipolar disorder.

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Lakshmanan, Manu N; Meier, Stacey L Colton; Meier, Robert S; Lakshmanan, Ramaswamy

2010-07-01

We present a case where dissociative identity disorder was effectively treated with memory retrieval psychotherapy. However, the patient's comorbid bipolar disorder contributed to the patient's instability and fortified the amnesiac barriers that exist between alter personality states in dissociative identity disorder, which made memory retrieval difficult to achieve. Implications from this case indicate that a close collaboration between psychologist and psychiatrist focused on carefully diagnosing and treating existing comorbid conditions may be the most important aspect in treating dissociative identity disorder. We present our experience of successfully treating a patient with dissociative identity disorder and bipolar disorder using this collaborative method.

Convergent paradigms for visual neuroscience and dissociative identity disorder.

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Manning, Mark L; Manning, Rana L

2009-01-01

Although dissociative identity disorder, a condition in which multiple individuals appear to inhabit a single body, is a recognized psychiatric disorder, patients may yet encounter health professionals who declare that they simply "do not believe in multiple personalities." This article explores the proposal that resistance to the disorder represents a failure to apply an appropriate paradigm from which the disorder should be interpreted. Trauma and sociocognitive explanations of dissociative identity disorder are contrasted. The trauma hypothesis is further differentiated into paradigms in which trauma affects a defense mechanism, and one in which trauma serves to inhibit the normal integration sequence of parallel processes of the self in childhood. This latter paradigm is shown to be broadly consistent with current models of cortical processing in another system, the cortical visual system.

Transfer of newly acquired stimulus valence between identities in dissociative identity disorder (DID).

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Huntjens, Rafaële J C; Peters, Madelon L; Postma, Albert; Woertman, Liesbeth; Effting, Marieke; van der Hart, Onno

2005-02-01

Patients with Dissociative Identity Disorder (DID) frequently report episodes of interidentity amnesia, that is amnesia for events experienced by other identities. The goal of the present experiment was to test the implicit transfer of trauma-related information between identities in DID. We hypothesized that whereas declarative information may transfer from one identity to another, the emotional connotation of the memory may be dissociated, especially in the case of negative, trauma-related emotional valence. An evaluative conditioning procedure was combined with an affective priming procedure, both performed by different identities. In the evaluative conditioning procedure, previously neutral stimuli come to refer to a negative or positive connotation. The affective priming procedure was used to test the transfer of this acquired valence to an identity reporting interidentity amnesia. Results indicated activation of stimulus valence in the affective priming task, that is transfer of emotional material between identities.

Axis-I comorbidity in female patients with dissociative identity disorder and dissociative identity disorder not otherwise specified.

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Rodewald, Frauke; Wilhelm-Göling, Claudia; Emrich, Hinderk M; Reddemann, Luise; Gast, Ursula

2011-02-01

The aim of this study was to investigate axis-I comorbidity in patients with dissociative identity disorder (DID) and dissociative disorder not otherwise specified (DDNOS). Using the Diagnostic Interview for Psychiatric Disorders, results from patients with DID (n = 44) and DDNOS (n = 22) were compared with those of patients with posttraumatic stress disorder (PTSD) (n = 13), other anxiety disorders (n = 14), depression (n = 17), and nonclinical controls (n = 30). No comorbid disorders were found in nonclinical controls. The average number of comorbid disorders in patients with depression or anxiety was 0 to 2. Patients with dissociative disorders averagely suffered from 5 comorbid disorders. The most prevalent comorbidity in DDNOS and DID was PTSD. Comorbidity profiles of patients with DID and DDNOS were very similar to those in PTSD (high prevalence of anxiety, somatoform disorders, and depression), but differed significantly from those of patients with depression and anxiety disorders. These findings confirm the hypothesis that PTSD, DID, and DDNOS are phenomenologically related syndromes that should be summarized within a new diagnostic category.

Dissociative identity disorder: An empirical overview.

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Dorahy, Martin J; Brand, Bethany L; Sar, Vedat; Krüger, Christa; Stavropoulos, Pam; Martínez-Taboas, Alfonso; Lewis-Fernández, Roberto; Middleton, Warwick

2014-05-01

Despite its long and auspicious place in the history of psychiatry, dissociative identity disorder (DID) has been associated with controversy. This paper aims to examine the empirical data related to DID and outline the contextual challenges to its scientific investigation. The overview is limited to DID-specific research in which one or more of the following conditions are met: (i) a sample of participants with DID was systematically investigated, (ii) psychometrically-sound measures were utilised, (iii) comparisons were made with other samples, (iv) DID was differentiated from other disorders, including other dissociative disorders, (v) extraneous variables were controlled or (vi) DID diagnosis was confirmed. Following an examination of challenges to research, data are organised around the validity and phenomenology of DID, its aetiology and epidemiology, the neurobiological and cognitive correlates of the disorder, and finally its treatment. DID was found to be a complex yet valid disorder across a range of markers. It can be accurately discriminated from other disorders, especially when structured diagnostic interviews assess identity alterations and amnesia. DID is aetiologically associated with a complex combination of developmental and cultural factors, including severe childhood relational trauma. The prevalence of DID appears highest in emergency psychiatric settings and affects approximately 1% of the general population. Psychobiological studies are beginning to identify clear correlates of DID associated with diverse brain areas and cognitive functions. They are also providing an understanding of the potential metacognitive origins of amnesia. Phase-oriented empirically-guided treatments are emerging for DID. The empirical literature on DID is accumulating, although some areas remain under-investigated. Existing data show DID as a complex, valid and not uncommon disorder, associated with developmental and cultural variables, that is amenable to

Frontal and occipital perfusion changes in dissociative identity disorder.

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Sar, Vedat; Unal, Seher N; Ozturk, Erdinc

2007-12-15

The aim of the study was to investigate if there were any characteristics of regional cerebral blood flow (rCBF) in dissociative identity disorder. Twenty-one drug-free patients with dissociative identity disorder and nine healthy volunteers participated in the study. In addition to a clinical evaluation, dissociative psychopathology was assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders, the Dissociative Experiences Scale and the Clinician-Administered Dissociative States Scale. A semi-structured interview for borderline personality disorder, the Hamilton Depression Rating Scale, and the Childhood Trauma Questionnaire were also administered to all patients. Normal controls had to be without a history of childhood trauma and without any depressive or dissociative disorder. Regional cerebral blood flow (rCBF) was studied with single photon emission computed tomography (SPECT) with Tc99m-hexamethylpropylenamine (HMPAO) as a tracer. Compared with findings in the control group, the rCBF ratio was decreased among patients with dissociative identity disorder in the orbitofrontal region bilaterally. It was increased in median and superior frontal regions and occipital regions bilaterally. There was no significant correlation between rCBF ratios of the regions of interest and any of the psychopathology scale scores. An explanation for the neurophysiology of dissociative psychopathology has to invoke a comprehensive model of interaction between anterior and posterior brain regions.

Apotemnophilia or body integrity identity disorder: a case report review.

Science.gov (United States)

Bou Khalil, Rami; Richa, Sami

2012-12-01

Apotemnophilia or body integrity identity disorder (BIID) denotes a syndrome in which a person is preoccupied with the desire to amputate a healthy limb. In this report, we review the available case reports in the literature in order to enhance psychiatrists' and physicians' comprehension of this disorder. A search for the case reports available via MEDLINE was done since the first case report published by Money et al in 1977 till May 2011, using the following terms: apotemnophilia, self-demand amputation, body integrity identity disorder, and BIID. In all, 14 case reports were found relevant to our search. The desire to amputate one's healthy limb seems to be related to a major disturbance in the person's perception of one's own identity, where limb amputation can relieve temporarily the patient's feeling of distress without necessarily and uniformly adjusting the patient's own identity misperception. More investigations are needed in this domain in order to develop noninvasive treatment strategies that approach this aspect of the patient's distress within a globalist perspective. In addition, the health professionals' awareness regarding this disorder is required to ensure professional management of patients' suffering.

[AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders].

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Schlüter-Müller, Susanne

2017-07-01

AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders Personality disorders are patterns of maladaptive personality traits that have an impact on the individual throughout the life span. Borderline Personality Disorder (BPD) is a very severe, but treatable mental disorder. Identity disturbance is seen as the central construct for detecting severe personality pathology - and, most notably, borderline personality disorder - in adults and adolescents. Crises in the development of identity usually resolve into a normal and consolidated identity with flexible and adaptive functioning whereas identity diffusion is viewed as a lack of integration of the concept of the self and significant others. It is seen as the basis for subsequent personality pathology, including that of borderline personality disorder. Although BPD has its onset in adolescence and emerging adulthood the diagnosis is often delayed. In most cases, specific treatment is only offered late in the course of the disorder and to relatively few individuals. Adolescent Identity Treatment (AIT) is a treatment model that focuses on identity pathology as the core characteristic of personality disorders. This model integrates specific techniques for the treatment of adolescent personality pathology on the background of object-relation theories and modified elements of Transference-Focused Psychotherapy. Moreover, psychoeducation, a behavior-oriented homeplan and intensive family work is part of AIT.

Gender identity disorder and autism spectrum disorder in a 23-year-old female.

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Lemaire, Mathieu; Thomazeau, Barbara; Bonnet-Brilhault, Frédérique

2014-02-01

We describe the case of a 23-year-old woman with Gender Identity Disorder (GID) asking for a cross-sex hormonal treatment with sex reassignment surgery and who was recently diagnosed with Autism Spectrum Disorder (ASD). Gender identity clinics are now reporting an overrepresentation of individuals with ASD among GID patients. The prevalence of ASD is 10-fold higher among GID patients than in general population. However, few case reports or studies have explored the co-occurrence of ASD and GID. This co-occurrence is relevant for diagnostic and clinical management and also raises important theoretical issues.

Symptom patterns in dissociative identity disorder patients and the general population.

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Ross, Colin A; Ness, Laura

2010-01-01

The authors used the Dissociative Disorders Interview Schedule to compare structured interview symptom patterns in a general population sample (N= 502) and a sample of patients with clinical diagnoses of dissociative identity disorder (N= 303). Based on the Trauma Model, the authors predicted that the patterns would be similar in the 2 samples and that symptom scores would be higher in participants reporting childhood sexual abuse in both samples. They predicted that symptom scores would be higher among women with dissociative identity disorder reporting sexual abuse than among women in the general population reporting sexual abuse, with the clinical sample reporting more severe abuse. These predictions were supported by the data. The authors conclude that symptom patterns in dissociative identity disorder are typical of the normal human response to severe, chronic childhood trauma and have ecological validity for the human race in general.

Memory transfer for emotionally valenced words between identities in dissociative identity disorder

NARCIS (Netherlands)

Huntjens, Rafaele J. C.; Peters, Madelon L.; Woertman, Liesbeth; van der Hart, Onno; Postma, Albert

The present study aimed to determine interidentity retrieval of emotionally valenced words in dissociative identity disorder (DID). Twenty-two DID patients participated together with 25 normal controls and 25 controls instructed to simulate DID. Two wordlists A and B were constructed including

Interidentity memory transfer in dissociative identity disorder.

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Kong, Lauren L; Allen, John J B; Glisky, Elizabeth L

2008-08-01

Controversy surrounding dissociative identity disorder (DID) has focused on conflicting findings regarding the validity and nature of interidentity amnesia, illustrating the need for objective methods of examining amnesia that can discriminate between explicit and implicit memory transfer. In the present study, the authors used a cross-modal manipulation designed to mitigate implicit memory effects. Explicit memory transfer between identities was examined in 7 DID participants and 34 matched control participants. After words were presented to one identity auditorily, the authors tested another identity for memory of those words in the visual modality using an exclusion paradigm. Despite self-reported interidentity amnesia, memory for experimental stimuli transferred between identities. DID patients showed no superior ability to compartmentalize information, as would be expected with interidentity amnesia. The cross-modal nature of the test makes it unlikely that memory transfer was implicit. These findings demonstrate that subjective reports of interidentity amnesia are not necessarily corroborated by objective tests of explicit memory transfer. Copyright (c) 2008 APA, all rights reserved.

Schizophrenia modifying the expression of gender identity disorder.

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Baltieri, Danilo Antonio; De Andrade, Arthur Guerra

2009-04-01

According to the Brazilian Federal Medical Association, transsexualism is recognized as a gender identity disorder if a long-term diagnostic therapeutic process has demonstrated that the transposition of gender roles is irreversible, and if only hormonal and surgical procedures are appropriate to relieve the stress associated with the gender identity. Although such treatment will only be initiated with caution and after a long phase of intense diagnostic screening, the differentiation between pure identity disorders and transsexual feelings secondary to an ongoing psychopathologic process, such as schizophrenia, can be arduous for many health professionals. To report a case of a female patient with schizophrenia and transsexualism and the risks of a potential diagnostic confusion. A 19-year-old black woman, with an 8-year history of undifferentiated schizophrenia and intense gender dysphoria, was referred for sex reassignment surgery evaluation in the Ambulatory for the Treatment of Sexual Disorders of the ABC Medical School. After a more adequate antipsychotic treatment, her masculine behavior has persisted, but her desire to change her own genital organs has decreased. A better acceptance of the multiplicity of possible genders should neither contribute to inadequate interpretations of the signs and symptoms of our patients nor facilitate dangerous clinical or surgical recommendations.

Objective documentation of child abuse and dissociation in 12 murderers with dissociative identity disorder.

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Lewis, D O; Yeager, C A; Swica, Y; Pincus, J H; Lewis, M

1997-12-01

The skepticism regarding the existence of dissociative identity disorder as well as the abuse that engenders it persists for lack of objective documentation. This is doubly so for the disorder in murderers because of issues of suspected malingering. This article presents objective verification of both dissociative symptoms and severe abuse during childhood in a series of adult murderers with dissociative identity disorder. This study consisted of a review of the clinical records of 11 men and one woman with DSM-IV-defined dissociative identity disorder who had committed murder. Data were gathered from medical, psychiatric, social service, school, military, and prison records and from records of interviews with subjects' family members and others. Handwriting samples were also examined. Data were analyzed qualitatively. Signs and symptoms of dissociative identity disorder in childhood and adulthood were corroborated independently and from several sources in all 12 cases; objective evidence of severe abuse was obtained in 11 cases. The subjects had amnesia for most of the abuse and underreported it. Marked changes in writing style and/or signatures were documented in 10 cases. This study establishes, once and for all, the linkage between early severe abuse and dissociative identity disorder. Further, the data demonstrate that the disorder can be distinguished from malingering and from other disorders. The study shows that it is possible, with great effort, to obtain objective evidence of both the symptoms of dissociative identity disorder and the abuse that engenders it.

Autonoesis and dissociative identity disorder.

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Morton, John

2018-01-01

Dissociative identity disorder is characterised by the presence in one individual of two or more alternative personality states (alters). For such individuals, the memory representation of a particular event can have full episodic, autonoetic status for one alter, while having the status of knowledge or even being inaccessible to a second alter. This phenomenon appears to create difficulties for a purely representational theory and is presented to Mahr & Csibra (M&C) for their consideration.

Demographics, behavior problems, and psychosexual characteristics of adolescents with gender identity disorder or transvestic fetishism.

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Zucker, Kenneth J; Bradley, Susan J; Owen-Anderson, Allison; Kibblewhite, Sarah J; Wood, Hayley; Singh, Devita; Choi, Kathryn

2012-01-01

This study provided a descriptive and quantitative comparative analysis of data from an assessment protocol for adolescents referred clinically for gender identity disorder (n = 192; 105 boys, 87 girls) or transvestic fetishism (n = 137, all boys). The protocol included information on demographics, behavior problems, and psychosexual measures. Gender identity disorder and transvestic fetishism youth had high rates of general behavior problems and poor peer relations. On the psychosexual measures, gender identity disorder patients had considerably greater cross-gender behavior and gender dysphoria than did transvestic fetishism youth and other control youth. Male gender identity disorder patients classified as having a nonhomosexual sexual orientation (in relation to birth sex) reported more indicators of transvestic fetishism than did male gender identity disorder patients classified as having a homosexual sexual orientation (in relation to birth sex). The percentage of transvestic fetishism youth and male gender identity disorder patients with a nonhomosexual sexual orientation self-reported similar degrees of behaviors pertaining to transvestic fetishism. Last, male and female gender identity disorder patients with a homosexual sexual orientation had more recalled cross-gender behavior during childhood and more concurrent cross-gender behavior and gender dysphoria than did patients with a nonhomosexual sexual orientation. The authors discuss the clinical utility of their assessment protocol.

The rise and fall of dissociative identity disorder.

Science.gov (United States)

Paris, Joel

2012-12-01

Dissociative identity disorder (DID), once considered rare, was frequently diagnosed during the 1980s and 1990s, after which interest declined. This is the trajectory of a medical fad. DID was based on poorly conceived theories and used potentially damaging treatment methods. The problem continues, given that the DSM-5 includes DID and accords dissociative disorders a separate chapter in its manual.

Inter-identity amnesia in dissociative identity disorder: a simulated memory impairment?

Science.gov (United States)

Huntjens, Rafaële J C; Peters, Madelon L; Woertman, Liesbeth; Bovenschen, Loes M; Martin, Roy C; Postma, Albert

2006-06-01

Although included in the current edition of the DSM, there does not seem to be consensus among mental health professionals regarding the diagnostic status and scientific validity of dissociative identity disorder (DID). This study was aimed at the detection of simulation of inter-identity amnesia in DID. A sample of 22 DID patients was included, together with a matched control sample of subjects instructed to simulate inter-identity amnesia, a guessor group that had no knowledge of the stimulus material and a normal control group. A multiple-choice recognition test was included. The rate of incorrect answers was determined. Moreover, the specific simulation strategy used was examined by providing subjects with a range of choices that varied in extent of disagreement with the correct answer and determining whether plausible or implausible answer alternatives were selected. On the recognition test DID patients selected incorrect answers above chance like simulators. Patients thus seem to use their knowledge of the correct answer in determining their given answer. They were not characterized by a well-thought-out simulating behaviour style, as indicated by the differences in selection of specific answer alternatives found between patients and simulators. DID patients were found not to be characterized by an actual memory retrieval inability, in contrast to their subjective reports. Instead, it is suggested that DID may more accurately be considered a disorder characterized by meta-memory problems, holding incorrect beliefs about their own memory functioning.

Dissociative identity disorder and pseudo-hysteria.

Science.gov (United States)

Foote, B

1999-01-01

The diagnostic validity of dissociative identity disorder (DID) continues to inspire controversy, with some commentators claiming that DID is a modern variant of "hysteria"; that is, attention-seeking behavior. The author asserts that DID is indeed a valid psychiatric disorder, and believes that this skeptical reaction can largely be attributed to a specific set of transference/countertransference interactions that these patients tend to inspire. The paper delineates several clinical features of DID that can easily be mistaken for hysterical phenomena, and attempts to find the roots of this confusion in the DID patients' experience of interpersonal powerlessness, which leads them to present their symptoms in an unconvincing, "hysterical" manner. Confusion between the vertical split seen in the dissociative disorders and the horizontal split characteristic of the classic hysterical personality is discussed, as is the powerful effect of observer bias in creating hysterical-appearing phenomena. The term "pseudo-hysteria" is used to denote a situation in which a genuine psychiatric disorder, DID, is perceived as an hysterical production.

Ethnicity, ethnic identity, self-esteem, and at-risk eating disordered behavior differences of urban adolescent females.

Science.gov (United States)

Rhea, Deborah J; Thatcher, W Gregory

2013-01-01

The purpose of this study was two-fold: to determine the relationship between ethnic identity and self-esteem as dimensions of one's self-concept; and to determine if differences exist among one's ethnicity, ethnic identity, and/or self-esteem when examining at-risk eating disordered behaviors. A total of 893 urban adolescent females completed three behavioral subscales: the Eating Disorder Inventory, Rosenberg's Self-Esteem Scale, and Phinney's Multigroup Ethnic Identity Measure. As hypothesized, ethnic identity was significantly associated with self-esteem to form one's self-concept. When compared to Mexican American and White females, only Black females who were in the higher ethnic identity and self-esteem categories had significantly lower at-risk eating disordered scores. Our findings suggest eating disorder status in Mexican American and White females may not be associated as much with ethnic identity as with other acculturation and self-concept factors. Further, this study demonstrated ethnicity, self-esteem, and ethnic identity play significant roles in eating disorder risks.

Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective

Directory of Open Access Journals (Sweden)

Şar V

2017-05-01

Full Text Available Vedat Şar,1 Martin J Dorahy,2 Christa Krüger3 1Department of Psychiatry, Koç University School of Medicine, Istanbul, Turkey; 2Department of Psychology, University of Canterbury, Christchurch, New Zealand; 3Department of Psychiatry, University of Pretoria, Pretoria, South Africa Abstract: Dissociative identity disorder (DID is a chronic post-traumatic disorder where developmentally stressful events in childhood, including abuse, emotional neglect, disturbed attachment, and boundary violations are central and typical etiological factors. Familial, societal, and cultural factors may give rise to the trauma and/or they may influence the expression of DID. Memory and the construction of self-identity are cognitive processes that appear markedly and centrally disrupted in DID and are related to its etiology. Enduring decoupling of psychological modes may create separate senses of self, and metamemory processes may be involved in interidentity amnesia. Neurobiological differences have been demonstrated between dissociative identities within patients with DID and between patients with DID and controls. Given the current evidence, DID as a diagnostic entity cannot be explained as a phenomenon created by iatrogenic influences, suggestibility, malingering, or social role-taking. On the contrary, DID is an empirically robust chronic psychiatric disorder based on neurobiological, cognitive, and interpersonal non-integration as a response to unbearable stress. While current evidence is sufficient to firmly establish this etiological stance, given the wide opportunities for innovative research, the disorder is still understudied. Comparison of well-selected samples of DID patients with non-dissociative subjects who have other psychiatric disorders would further delineate the neurobiological and cognitive features of the disorder, whereas genetic research on DID would further illuminate the interaction of the individual with environmental stress. As such

Review: Gender Identity Disorders in Childhood and Adolescence

Directory of Open Access Journals (Sweden)

Mohammad Reza Mohammadi

2000-10-01

Full Text Available Gender identity includes individual sense of being male or female personality. Which will has been typical figured by the ages of 3 or 4 years. There are two criteria in DSM-IV A A strong and steady identification with opposite sex, B Inappropriate permanent feeling with self gender or unsuitable belief in self gender role. The frequency of this disorder have consisted various rates of 6-16% among nonformal epidemiologic studies. In order to evaluate of this disorder, we would already consider the parents reports, behavioral methods projective techniques. Meanwhile depression, behavioral abnormality and personality disorders can he figured as comorbidities of GID. There is no exact known relationship between sexual – orientation and sexual identification. It's been revealed bio-psycho-social etiological influenced factors in this case. On basis of Zucher, Bradly and Coates theorical models, exposed that there are usually two interactive factors which known as the major causes of gender Identity disorder: A general main factor which enforces the child anxiety and as a specific factor that poses dynamically among family members or in child own himself/herself. Behavioral techniques, psychoanalysis and family training can be considered as management modalities, but personal and self authorization, particularly within concern to comorbidities other psychosocial problems are felt so great importance.

Gender identity and sexual orientation in women with borderline personality disorder.

Science.gov (United States)

Singh, Devita; McMain, Shelley; Zucker, Kenneth J

2011-02-01

In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text revision (DSM-IV-TR) (and earlier editions), a disturbance in "identity" is one of the defining features of borderline personality disorder (BPD). Gender identity, a person's sense of self as a male or a female, constitutes an important aspect of identity formation, but this construct has rarely been examined in patients with BPD. In the present study, the presence of gender identity disorder or confusion was examined in women diagnosed with BPD. We used a validated dimensional measure of gender dysphoria. Recalled gender identity and gender role behavior from childhood was also assessed with a validated dimensional measure, and current sexual orientation was assessed by two self-report measures. A consecutive series of 100 clinic-referred women (mean age, 34 years) with BPD participated in the study. The women were diagnosed with BPD using the International Personality Disorder Exam-BPD Section. None of the women with BPD met the criterion for caseness on the dimensional measure of gender dysphoria. Women who self-reported either a bisexual or a homosexual sexual orientation had a significantly higher score on the dimensional measure of gender dysphoria than the women who self-reported a heterosexual sexual orientation, and they also recalled significantly more cross-gender behavior during childhood. Results were compared with a previous study on a diagnostically heterogeneous group of women with other clinical problems. The importance of psychosexual assessment in the clinical evaluation of patients with BPD is discussed. © 2010 International Society for Sexual Medicine.

An Archetype of the Collaborative Efforts of Psychotherapy and Psychopharmacology in Successfully Treating Dissociative Identity Disorder with Comorbid Bipolar Disorder

OpenAIRE

Lakshmanan, Manu N.; Meier, Stacey L. Colton; Meier, Robert S.; Lakshmanan, Ramaswamy

2010-01-01

We present a case where dissociative identity disorder was effectively treated with memory retrieval psychotherapy. However, the patient’s comorbid bipolar disorder contributed to the patient’s instability and fortified the amnesiac barriers that exist between alter personality states in dissociative identity disorder, which made memory retrieval difficult to achieve. Implications from this case indicate that a close collaboration between psychologist and psychiatrist focused on carefully dia...

Opposite brain emotion-regulation patterns in identity states of dissociative identity disorder : A PET study and neurobiological model

NARCIS (Netherlands)

Reinders, Antje A. T. S.; Willemsen, Antoon T. M.; den Boer, Johan A.; Vos, Herry P. J.; Veltman, Dick J.; Loewenstein, Richard J.

2014-01-01

Imaging studies in posttraumatic stress disorder (PTSD) have shown differing neural network patterns between hypo-aroused/dissociative and hyper-aroused subtypes. Since dissociative identity disorder (DID) involves different emotional states, this study tests whether DID fits aspects of the

Personality disorders in persons with gender identity disorder.

Science.gov (United States)

Duišin, Dragana; Batinić, Borjanka; Barišić, Jasmina; Djordjevic, Miroslav L; Vujović, Svetlana; Bizic, Marta

2014-01-01

Investigations in the field of gender identity disorder (GID) have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality and personality disorders (PDs). The aim of the study was to assess the presence of PDs in persons with GID as compared to cisgendered (a cisgender person is a person who is content to remain the gender they were assigned at birth) heterosexuals, as well as to biological sex. The study sample consisted of 30 persons with GID and 30 cisgendered heterosexuals from the general population. The assessment of PDs was conducted by application of the self-administered Structured Clinical Interview for DSM-IV Axis II PDs (SCID-II). Persons with GID compared to cisgender heterosexuals have higher presence of PDs, particularly Paranoid PD, avoidant PDs, and comorbid PDs. In addition, MtF (transwomen are people assigned male at birth who identify as women) persons are characterized by a more severe psychopathological profile. Assessment of PDs in persons with GID is of great importance as it comprises a key part of personalized treatment plan tailoring, as well as a prognostic factor for sex-reassignment surgery (SRS) outcome.

Schizophrenia masquerading as Dissociative Identity Disorder

OpenAIRE

Jegan Yogaratnam; Rajesh Jacob

2012-01-01

Dissociative symptoms can dominate the clinical picture in many psychiatric conditions and possess a huge challenge to the clinicians in management. We present a case report of a female with a strong family history of schizophrenia who initially presented with features suggestive of dissociative identity disorder, which is itself a rare clinical entity, was later diagnosed to have schizophrenia. Authors would like to emphasise that clinicians should have a high index of suspicion for schizoph...

Management challenges in a case of gender identity disorder

Directory of Open Access Journals (Sweden)

Anubhav Rathi

2014-01-01

Full Text Available Gender identity disorder (GID is a complex disorder and can be defined as a group of disorders whose common feature is a strong and persistent preference for living as a person of the other sex. It is associated with significant impairment in social, occupational, interpersonal, and other areas of functioning. We describe the case of an adolescent, biologically male who was brought to our outpatient department primarily with symptoms of adjustment disorder with GID and the management provided. The role of a psychiatrist in the management, ethical and legal issues involved is also discussed.

[Diagnosis and treatment of gender identity disorder].

Science.gov (United States)

Yamauchi, Toshio

2004-02-01

According to DSM-IV criteria, gender identity disorder(GID) is characterized as follows: 1) Strong, persistent cross-gender identification. 2) Persistent discomfort with one's assigned sex or the Sense of inappropriateness in that gender role. 3) Not due to an intersex condition. In this chapter, symptoms, diagnosis and treatment of GID are briefly described. Possible pathogenesis of GID is also discussed.

Feminist identity, body image, and disordered eating

Science.gov (United States)

Borowsky, Hannah M.; Eisenberg, Marla E.; Bucchianeri, Michaela M.; Piran, Niva; Neumark-Sztainer, Dianne

2016-01-01

Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors. PMID:26694553

Feminist identity, body image, and disordered eating.

Science.gov (United States)

Borowsky, Hannah M; Eisenberg, Marla E; Bucchianeri, Michaela M; Piran, Niva; Neumark-Sztainer, Dianne

2016-01-01

Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors.

Personality Disorders in Persons with Gender Identity Disorder

Directory of Open Access Journals (Sweden)

Dragana Duišin

2014-01-01

Full Text Available Background. Investigations in the field of gender identity disorder (GID have been mostly related to psychiatric comorbidity and severe psychiatric disorders, but have focused less on personality and personality disorders (PDs. Aims. The aim of the study was to assess the presence of PDs in persons with GID as compared to cisgendered (a cisgender person is a person who is content to remain the gender they were assigned at birth heterosexuals, as well as to biological sex. Methods. The study sample consisted of 30 persons with GID and 30 cisgendered heterosexuals from the general population. The assessment of PDs was conducted by application of the self-administered Structured Clinical Interview for DSM-IV Axis II PDs (SCID-II. Results. Persons with GID compared to cisgender heterosexuals have higher presence of PDs, particularly Paranoid PD, avoidant PDs, and comorbid PDs. In addition, MtF (transwomen are people assigned male at birth who identify as women persons are characterized by a more severe psychopathological profile. Conclusions. Assessment of PDs in persons with GID is of great importance as it comprises a key part of personalized treatment plan tailoring, as well as a prognostic factor for sex-reassignment surgery (SRS outcome.

Thoughts on the nature of identity: how disorders of sex development inform clinical research about gender identity disorders.

Science.gov (United States)

Reiner, William G; Reiner, D Townsend

2012-01-01

Disorders of sex development (DSD), like gender dysphoria, are conditions with major effects on child sexuality and identity, as well as sexual orientation. Each may in some cases lead to change of gender from that assigned neonatally. These similarities-and the conditions' differences-provide a context for reviewing the articles in this issue about clinical approaches to children with gender dysphoria, in relation to assessment, intervention, and ethics.

Revisiting the etiological aspects of dissociative identity disorder: a biopsychosocial perspective.

Science.gov (United States)

Şar, Vedat; Dorahy, Martin J; Krüger, Christa

2017-01-01

Dissociative identity disorder (DID) is a chronic post-traumatic disorder where developmentally stressful events in childhood, including abuse, emotional neglect, disturbed attachment, and boundary violations are central and typical etiological factors. Familial, societal, and cultural factors may give rise to the trauma and/or they may influence the expression of DID. Memory and the construction of self-identity are cognitive processes that appear markedly and centrally disrupted in DID and are related to its etiology. Enduring decoupling of psychological modes may create separate senses of self, and metamemory processes may be involved in interidentity amnesia. Neurobiological differences have been demonstrated between dissociative identities within patients with DID and between patients with DID and controls. Given the current evidence, DID as a diagnostic entity cannot be explained as a phenomenon created by iatrogenic influences, suggestibility, malingering, or social role-taking. On the contrary, DID is an empirically robust chronic psychiatric disorder based on neurobiological, cognitive, and interpersonal non-integration as a response to unbearable stress. While current evidence is sufficient to firmly establish this etiological stance, given the wide opportunities for innovative research, the disorder is still understudied. Comparison of well-selected samples of DID patients with non-dissociative subjects who have other psychiatric disorders would further delineate the neurobiological and cognitive features of the disorder, whereas genetic research on DID would further illuminate the interaction of the individual with environmental stress. As such, DID may be seen as an exemplary disease model of the biopsychosocial paradigm in psychiatry.

Comparing the symptoms and mechanisms of "dissociation" in dissociative identity disorder and borderline personality disorder.

Science.gov (United States)

Laddis, Andreas; Dell, Paul F; Korzekwa, Marilyn

2017-01-01

A total of 75 patients were diagnosed with the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised as having dissociative identity disorder (DID), and 100 patients were diagnosed with the Structured Interview for DSM-IV Personality as having borderline personality disorder (BPD). Both groups were administered the Multidimensional Inventory of Dissociation (MID). DID patients had significantly higher MID scores than BPD patients, different distributions of MID scores, and different MID subscale profiles in 3 ranges of MID scores (0-15, 15-30, 30-45). The core MID symptoms-exhibited at all ranges of MID scores-for DID patients (the presence of alters, identity confusion, and memory problems) and BPD patients (flashbacks, identity confusion, and memory problems) were ostensibly similar but were considered to be mostly produced by different underlying processes. Multiple regression analyses showed that the core MID symptoms of DID patients had different predictors than did the core MID symptoms of BPD patients. Alter identities seemed to generate most-but not all-dissociative phenomena in DID patients, whereas only the 24% highest scoring BPD patients (MID ≥45) seemed to manifest alter-driven dissociative experiences. Most BPD dissociative experiences appeared to be due to 5 other mechanisms: (a) BPD-specific, stress-driven, rapid shifts of self-state; (b and c) nondefensive disruptions of the framework of perceptual organization with or without an accompanying BPD-specific, dissociation-like disintegration of affective/neurocognitive functioning; (d) a defensive distancing or detachment from distress (i.e., simple depersonalization); and (e) Allen, Console, and Lewis's (1999) severe absorptive detachment.

[Gender identity disorder in children and adolescents].

Science.gov (United States)

Le Heuzey, M-F

2013-03-01

There has been an explosion of public interest and concern about children and adolescents who show an interest in changing their gender. And it is an emerging problem for pediatricians, which brings many inquiries about what to do? Both the diagnosis and treatment of gender identity disorder are controversial. But there are a new early treatment using puberty blocking hormones. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Dissociative identity disorder and schizophrenia: differential diagnosis and theoretical issues.

Science.gov (United States)

Foote, Brad; Park, Jane

2008-06-01

Schizophrenia and dissociative identity disorder (DID) are typically thought of as unrelated syndromes--a genetically based psychotic disorder versus a trauma-based dissociative disorder--and are categorized as such by the DSM-IV. However, substantial data exist to document the elevated occurrence of psychotic symptoms in DID; awareness of these features is necessary to prevent diagnostic confusion. Recent research has also pointed out that schizophrenia and DID overlap not only in psychotic symptoms but also in terms of traumatic antecedents, leading to a number of suggestions for revision of our clinical, theoretical, and nosologic understanding of the relationship between these two disorders.

Gender identity disorder.

LENUS (Irish Health Repository)

De Gascun, C

2006-05-01

Gender Identity Disorder (GID) is a relatively rare condition of atypical gender development in which there is a psychological perception of self as masculine or feminine which is incongruent with ones phenotype. GID replaced the term Transsexualism in DSM-IV in 1994. The demographics of GID in Ireland have not been established. Since 2000 we have received 52 referrals of individuals with confirmed GID to our endocrine service for consideration for hormonal treatment (HT). Of the 52 patients 45 have male to female (MTF) GID (mean age 38.9 years) and 7 have female to male (FTM) GID (mean age 30.7 years). The age at presentation in this group is approximately 9 years older than in international series for both MTF (39 years v 30yrs) and FTM (31 yrs v 22yrs). The karyotype where analysed has been normal for their phenotypic sex. Twenty-three of the patients had received HT prior to attending our clinic that in only one case had been prescribed by a specialist. A number of patients had obtained HT via the internet or from overseas sources without medical review. Eighteen of the patients have been or are married and 14 of the group have children. The scale of referrals confirms that GID exists in the Irish population to a significant degree. Thus an appropriate care pathway for people with the condition needs to be established. This will facilitate optimum medical management of the patient group and a coherent approach to the many difficult social issues faced individuals with this disorder.

Puberty suppression in gender identity disorder: the Amsterdam experience

NARCIS (Netherlands)

Kreukels, B.P.C.; Cohen-Kettenis, P.T.

2011-01-01

The use of gonadotropin-releasing hormone analogs (GnRHa) to suppress puberty in adolescents with gender dysphoria is a fairly new intervention in the field of gender identity disorders or transsexualism. GnRHa are used to give adolescents time to make balanced decisions on any further treatment

Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder

NARCIS (Netherlands)

Chalavi, Sima; Vissia, Eline M.; Giesen, Mechteld E.; Nijenhuis, Ellert R. S.; Draijer, Nel; Barker, Gareth J.; Veltman, Dick J.; Reinders, Antje A. T. S.

2015-01-01

Neuroanatomical evidence on the relationship between posttratimatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16

Dissociative Identity Disorder in Felonious Offenders: Two Case Studies.

Science.gov (United States)

Culiner, Ty

1997-01-01

Describes the case studies of two inmates detained in a maximum security prison having been diagnosed with Dissociative Identity Disorder and receiving individual therapy. Although treatment is ongoing, mid-treatment progress indicates the treatment is successful and the prognosis is excellent. Accentuates the practicality and rewards of working…

Mirror Writing and a Dissociative Identity Disorder

OpenAIRE

Le, Catherine; Smith, Joyce; Cohen, Lewis

2009-01-01

Individuals with dissociative identity disorder (DID) have been known to show varied skills and talents as they change from one dissociative state to another. For example, case reports have described people who have changed their handedness or have spoken foreign languages during their dissociative states. During an interview with a patient with DID, a surprising talent emerged when she wrote a sentence for the Folstein Mini-Mental State Exam—mirror writing. It is not known whether her mirror...

I was the murderer! Or the Dissociative Identity Disorder in the cinema

Directory of Open Access Journals (Sweden)

Beatriz Vera Poseck

2008-10-01

Full Text Available The cinema has been especially attracted by the portrayal of mental illness and those suffering from it. Of all the disturbances of the human mind currently known, Dissociative Identity Disorder (previously known as multiple personality disorder is undoubtedly the one that has best served script-writers and directors in their films. The surprising manifestations of this illness mean that it is particularly suited as a support for some rather elusive and effect-oriented plots based on unexpected turns of the action that spark the surprise of the spectator. However, the marked interest of the seventh art in dissociative identity disorder has not led to a correct interpretation of the pathology; quite the contrary, in most cases it has been presented in a mistaken and confusing light.

Cross-examining dissociative identity disorder : Neuroimaging and etiology on trial

NARCIS (Netherlands)

Reinders, A. A. T. Simone

2008-01-01

Dissociative identity disorder (DID) is probably the most disputed of psychiatric diagnoses and of psychological forensic evaluations in the legal arena. The iatrogenic proponents assert that DID phenomena originate from psychotherapeutic treatment while traumagenic proponents state that DID

Cognitive Abuse within the Incestuous Family as a Factor in the Development of Dissociative Identity Disorder

Science.gov (United States)

Reed-Gavish, Maya

2013-01-01

The polarized nature of the ongoing controversies surrounding the genesis and validity of dissociative identity disorder pit advocates who see and work with dissociative identity disorder sufferers against skeptics who claim it to be an artificial iatrogenically produced phenomenon. This paper suggests that such a dichotomy is unwarranted and…

Abnormal Hippocampal Morphology in Dissociative Identity Disorder and Post-Traumatic Stress Disorder Correlates with Childhood Trauma and Dissociative Symptoms

NARCIS (Netherlands)

Chalavi, Sima; Vissia, Eline M.; Giesen, Mechteld E.; Nijenhuis, Ellert R. S.; Draijer, Nel; Cole, James H.; Dazzan, Paola; Pariante, Carmine M.; Madsen, Sarah K.; Rajagopalan, Priya; Thompson, Paul M.; Toga, Arthur W.; Veltman, Dick J.; Reinders, Antje A. T. S.

Smaller hippocampal volume has been reported in individuals with post-traumatic stress disorder (PTSD) and dissociative identity disorder (DID), but the regional specificity of hippocampal volume reductions and the association with severity of dissociative symptoms and/or childhood traumatization

Abnormal Hippocampal Morphology in Dissociative Identity Disorder and Post-Traumatic Stress Disorder Correlates with Childhood Trauma and Dissociative Symptoms

NARCIS (Netherlands)

Chalavi, S.; Vissia, E.M.; Giesen, M.E.; Nijenhuis, E.R.S.; Draijer, N.; Cole, J.H.; Dazzan, P.; Pariante, C.M.; Madsen, S.K.; Rajagopalan, P.; Thompson, P.M.; Toga, A.W.; Veltman, D.J.; Reinders, A.A.T.S

2015-01-01

Smaller hippocampal volume has been reported in individuals with post-traumatic stress disorder (PTSD) and dissociative identity disorder (DID), but the regional specificity of hippocampal volume reductions and the association with severity of dissociative symptoms and/or childhood traumatization

Predicting stabilizing treatment outcomes for complex posttraumatic stress disorder and dissociative identity disorder: an expertise-based prognostic model

NARCIS (Netherlands)

Baars, E.W.; van der Hart, O.; Nijenhuis, E.R.S.; Chu, J.A.; Glas, G.; Draaijer, N.

2011-01-01

The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID).We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex

Fighting the Whole System: Dissociative Identity Disorder, Labeling Theory, and Iatrogenic Doubting.

Science.gov (United States)

Floris, Jessica; McPherson, Susan

2015-01-01

This research examines how individuals diagnosed with dissociative identity disorder construe their experiences of being labeled with a contested diagnosis. Semistructured interviews were conducted in the United Kingdom with 5 women and 2 men diagnosed with dissociative identity disorder. A framework analysis was conducted. The analysis identified 2 overarching themes: diagnosis cross-examined and navigating care systems. The diagnosis appeared to be continually assessed by participants for its fit with symptoms, and the doubt among professionals seemed to be unhelpfully reflected in participants' attempts to understand and come to terms with their experiences. The findings are considered in light of labeling theory, the iatrogenic effects of professional doubt, and current debates concerning the reliability and validity of psychiatric diagnostic systems that have been reinvigorated by the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Change in Identity Diffusion and Psychopathology in a Specialized Inpatient Treatment for Borderline Personality Disorder.

Science.gov (United States)

Sollberger, Daniel; Gremaud-Heitz, Daniela; Riemenschneider, Anke; Agarwalla, Puspa; Benecke, Cord; Schwald, Oliver; Küchenhoff, Joachim; Walter, Marc; Dammann, Gerhard

2015-01-01

Patients with borderline personality disorder (BPD) show various psychopathological symptoms and suffer especially from disturbance in their identity. The purpose of the study was to investigate changes-particularly in affective BPD symptoms and identity diffusion-during a structured, disorder-specific inpatient treatment (DST) that combined a psychodynamic transference-focused psychotherapy approach with modules of dialectical behavioural skills training. In a prospective, two-group comparison trial, 44 patients with BPD were assessed with questionnaires addressing identity diffusion and state, as well as trait affective psychopathology, before and after 12 weeks of inpatient treatment. Thirty-two patients received DST, whereas 12 patients were given inpatient treatment-as-usual (TAU). The patients were allocated in a non-random procedure for two groups, in order of admission and availability of treatment options in the DST unit. In the pre-post-comparison, the DST group showed a significant decrease in identity diffusion (p borderline symptomatology and in the personality structure feature of identity diffusion. This highlights the significance of a short-term specific inpatient therapy for BPD. A structured, disorder-specific inpatient treatment of patients diagnosed with borderline personality disorder (BPD) combined a psychodynamic transference-focused psychotherapy treatment approach (focusing on pathological features in personality organization, particularly on non-integrated images of self and others) with modules of dialectical behavioural skills training. This treatment is associated with a decrease in identity diffusion of these patients after 12 weeks of treatment. The treatment is also related to a significant decrease in borderline typical psychopathological symptoms such as depressive symptoms, as well as an improvement in state anger. The outcomes of this structured, disorder-specific inpatient treatment of severely ill BPD patients indicated

Parametric Ward-Takahashi identity in disordered systems and the integral identity associated with the Calogero-Sutherland model

International Nuclear Information System (INIS)

Taniguchi, N.

1997-01-01

By utilizing the symmetric property known as the Ward-Takahashi identity in disordered systems, we explore the novel symmetry relations which hold in one-dimensional systems with inverse square interaction (the Calogero-Sutherland model). The identities emerge totally from the algebraic structure of the model. They show that the dynamical correlators are connected with one another, involving the higher-order integrals of motion. We obtain the result for the coupling strengths λ=1/2, 1, and 2, and conjecture that a similar relation may hold for arbitrary rational λ. copyright 1997 The American Physical Society

Body integrity identity disorder: from a psychological to a neurological syndrome.

Science.gov (United States)

Sedda, Anna

2011-12-01

Body Integrity Identity Disorder (BIID) is a condition in which individuals experience an intense desire for amputation of an healthy limb. Recently, McGeoch and colleagues provided the first direct evidence that this syndrome may be neurological rather than psychological in its origin. However, before including BIID in body ownership disorders, several concerns should be clarified, exploring other components of body representation and not only somatosensory perception.

Psychobiological characteristics of dissociative identity disorder: a symptom provocation study.

Science.gov (United States)

Reinders, A A T Simone; Nijenhuis, Ellert R S; Quak, Jacqueline; Korf, Jakob; Haaksma, Jaap; Paans, Anne M J; Willemsen, Antoon T M; den Boer, Johan A

2006-10-01

Dissociative identity disorder (DID) patients function as two or more identities or dissociative identity states (DIS), categorized as 'neutral identity states' (NIS) and 'traumatic identity states' (TIS). NIS inhibit access to traumatic memories thereby enabling daily life functioning. TIS have access and responses to these memories. We tested whether these DIS show different psychobiological reactions to trauma-related memory. A symptom provocation paradigm with 11 DID patients was used in a two-by-two factorial design setting. Both NIS and TIS were exposed to a neutral and a trauma-related memory script. Three psychobiological parameters were tested: subjective ratings (emotional and sensori-motor), cardiovascular responses (heart rate, blood pressure, heart rate variability) and regional cerebral blood flow as determined with H(2)(15)O positron emission tomography. Psychobiological differences were found for the different DIS. Subjective and cardiovascular reactions revealed significant main and interactions effects. Regional cerebral blood flow data revealed different neural networks to be associated with different processing of the neutral and trauma-related memory script by NIS and TIS. Patients with DID encompass at least two different DIS. These identities involve different subjective reactions, cardiovascular responses and cerebral activation patterns to a trauma-related memory script.

Normative identity construction among women diagnosed with a gambling disorder.

Science.gov (United States)

Gavriel-Fried, Belle; Peled, Einat; Ajzenstadt, Mimi

2015-03-01

Women with a gambling problem bear a negative social stigma. Based on the theory of symbolic interactionism, this study examined the construction of social identities by 17 Israeli women diagnosed with a gambling disorder. Interpretive interactionist analysis revealed how they construct their identity through correspondence with patterns of behavior that are perceived as normative, and identified 3 major themes: "I'm not actually a gambler" (the presentation of a multidimensional identity comprising other identities besides that of a gambler); "Staying normative during gambling"; and "I have changed" (reformed gamblers' presentation of themselves as having changed for the better). The findings underscore the complex dialogue behind the identity construction put forward by women with a gambling problem, their yearning to be perceived by society as normative women and to fit in despite their stigmatized behavior, and the tension they feel in society's relationship toward them. The findings also suggest that practitioners who work with women gamblers may want to pay attention to the power relations shaping identity construction in an interview setting, and look more closely at the women's awareness of the stigma they bear and the complex processes that make up their multidimensional identity. (c) 2015 APA, all rights reserved).

Changes in intensity of neurotic symptoms associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

Science.gov (United States)

Rodziński, Paweł; Rutkowski, Krzysztof; Murzyn, Agnieszka; Sobański, Jerzy A; Cyranka, Katarzyna; Dembińska, Edyta; Grządziel, Karolina; Klasa, Katarzyna; Mielimąka, Michał; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna

2017-06-18

Analysis of associations between changes in the intensity of neurotic symptoms and reduction of suicidal ideation (SI) or lack of SI reduction, in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach in a day hospital. Symptom Checklist KO"O" and Life Inventory completed by 461 women and 219 men treated in the psychotherapeutic day hospital due to neurotic, behavioral or personality disorders between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. The reduction of neurotic symptoms intensity was greater in patients of both genders who improved in terms of SI than in those who did not. This referred to global intensity of neurotic symptoms (OWK coefficient) in both genders (ppsychotherapy as a treatment method that leads to improvement in terms of both SI and neurotic symptoms. This suggests that the applied therapy may be effective in preventing suicidality in this group of patients. The observed associations also point in favor of hypothesis on similarities in etiopathogenesis of and partly identical personality-related factors predisposing to SI and neurotic disorders.

Possession experiences in dissociative identity disorder: a preliminary study.

Science.gov (United States)

Ross, Colin A

2011-01-01

Dissociative trance disorder, which includes possession experiences, was introduced as a provisional diagnosis requiring further study in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Consideration is now being given to including possession experiences within dissociative identity disorder (DID) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), which is due to be published in 2013. In order to provide empirical data relevant to the relationship between DID and possession states, I analyzed data on the prevalence of trance, possession states, sleepwalking, and paranormal experiences in 3 large samples: patients with DID from North America; psychiatric outpatients from Shanghai, China; and a general population sample from Winnipeg, Canada. Trance, sleepwalking, paranormal, and possession experiences were much more common in the DID patients than in the 2 comparison samples. The study is preliminary and exploratory in nature because the samples were not matched in any way.

Gender identity and gender role orientation in female assigned patients with disorders of sex development.

Science.gov (United States)

Mattila, Aino K; Fagerholm, Riitta; Santtila, Pekka; Miettinen, Päivi J; Taskinen, Seppo

2012-11-01

Gender identity and gender role orientation were assessed in 24 female assigned patients with disorders of sex development. A total of 16 patients were prenatally exposed to androgens, of whom 15 had congenital adrenal hyperplasia and 1 was virilized due to maternal tumor. Eight patients had 46,XY karyotype, of whom 5 had partial and 3 had complete androgen insensitivity syndrome. Gender identity was measured by the 27-item Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults with 167 female medical students as controls, and gender role was assessed by the femininity and masculinity subscales of the 30-item Bem Sex Role Inventory with 104 female and 64 male medical students as controls. No patient reached the cutoff for gender identity disorder on the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults. However, patients with 46,XY karyotype demonstrated a somewhat more conflicted gender identity, although the overall differences were relatively small. As to gender role orientation, patients with complete androgen insensitivity syndrome had high scores on the femininity and masculinity scales of the Bem Sex Role Inventory, which made them the most androgynous group. Our findings, although clinically not clear cut, suggest that patients with disorders of sex development are a heterogeneous group regarding gender identity and gender role outcomes, and that this issue should be discussed with the family when treatment plans are made. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Concerns and Issues in Treating Children of Parents Diagnosed with Dissociative Identity Disorder.

Science.gov (United States)

Boat, Barbara W.; Peterson, Gary

1997-01-01

Describes reasons why therapists may hesitate to address the needs of children when treating parents with Dissociative Identity Disorder (DID) (formerly Multiple Personality Disorder). Summarizes the literature supporting assessment of these children, relates clinical observations on the potential impact of DID on children, and suggests…

Clinical Assessment of Dissociative Identity Disorder among College Counseling Clients

Science.gov (United States)

Levy, Benjamin; Swanson, Janine E.

2008-01-01

College counseling professionals address a wide range of complex student mental health concerns. Among these, accurately identifying client presentations of dissociative identity disorder (DID) can be especially challenging because students with DID sometimes present as if they are experiencing another problem, such as a mood, anxiety, or…

Considerations for the Treatment of Children with Gender Identity Disorder.

Science.gov (United States)

Bergin, Audrey E.; Niclas, Mary Ann

1996-01-01

The treatment of children with Gender Identity Disorder is laden with important ethical and moral considerations. Gender-typed behavior is defined by culture; therefore, it is of paramount importance that therapists clarify their own biases and expectations of gender-based behavior before attempting treatment. Two case studies are presented. (LSR)

The mirror has two faces: dissociative identity disorder and the defence of pathological criminal incapacity--a South African criminal law perspective.

Science.gov (United States)

Stevens, Philip

2013-03-01

Dissociative identity disorder poses numerous medico legal issues whenever the insanity defence emerges. Within the context of the South African criminal law, the impact of dissociative identity disorder on criminal responsibility has only been addressed very briefly in one decided case. Various questions arise as to the impact that the distinctive diagnostic features of dissociative identity disorder could possibly have on the defence of pathological criminal incapacity, or better known as the insanity defence, within the ambit of the South African criminal law. In this contribution the author reflects on the mental disorder known as dissociative identity disorder or multiple personality disorder, against the backdrop of the defence of pathological criminal incapacity. Reflections are also provided pertaining to the various medico legal issues at stake whenever this defence has to be adjudicated upon.

Women's Auto/Biography and Dissociative Identity Disorder: Implications for Mental Health Practice.

Science.gov (United States)

Tomlinson, Kendal; Baker, Charley

2017-09-06

Dissociative Identity Disorder (DID) is an uncommon disorder that has long been associated with exposure to traumatic stressors exceeding manageable levels commonly encompassing physical, psychological and sexual abuse in childhood that is prolonged and severe in nature. In DID, dissociation continues after the traumatic experience and produces a disruption in identity where distinct personality states develop. These personalities are accompanied by variations in behaviour, emotions, memory, perception and cognition. The use of literature in psychiatry can enrich comprehension over the subjective experience of a disorder, and the utilisation of 'illness narratives' in nursing research have been considered a way of improving knowledge about nursing care and theory development. This research explores experiences of DID through close textual reading and thematic analysis of five biographical and autobiographical texts, discussing the lived experience of the disorder. This narrative approach aims to inform empathetic understanding and support the facilitation of therapeutic alliances in mental healthcare for those experiencing the potentially debilitating and distressing symptoms of DID. Although controversies surrounding the biomedical diagnosis of DID are important to consider, the lived experiences of those who mental health nurses encounter should be priority.

Beyond the Impasse - Reflections on Dissociative Identity Disorder from a Freudian-Lacanian Perspective.

Science.gov (United States)

Meganck, Reitske

2017-01-01

Dissociative identity disorder (DID) is a widely contested diagnosis. The dominant posttraumatic model (PTM) considers early life trauma to be the direct cause of the creation of alter identities and assumes that working directly with alter identities should be at the core of the therapeutic work. The socio-cognitive model, on the other hand, questions the validity of the DID diagnosis and proposes an iatrogenic origin of the disorder claiming that reigning therapeutic and socio-cultural discourses create and reify the problem. The author argues that looking at the underlying psychical dynamics can provide a way out of the debate on the veracity of the diagnosis. A structural conception of hysteria is presented to understand clinical and empirical observations on the prevalence, appearance and treatment of DID. On a more fundamental level, the concept of identification and the fundamental division of human psychic functioning are proposed as crucial for understanding the development and treatment of DID.

Comparison of brazilian spiritist mediumship and dissociative identity disorder.

Science.gov (United States)

Moreira-Almeida, Alexander; Neto, Francisco Lotufo; Cardeña, Etzel

2008-05-01

We studied the similarities and differences between Brazilian Spiritistic mediums and North American dissociative identity disorder (DID) patients. Twenty-four mediums selected among different Spiritistic organizations in São Paulo, Brazil, were interviewed using the Dissociative Disorder Interview Schedule, and their responses were compared with those of DID patients described in the literature. The results from Spiritistic mediums were similar to published data on DID patients only with respect to female prevalence and high frequency of Schneiderian first-rank symptoms. As compared with individuals with DID, the mediums differed in having better social adjustment, lower prevalence of mental disorders, lower use of mental health services, no use of antipsychotics, and lower prevalence of histories of physical or sexual childhood abuse, sleepwalking, secondary features of DID, and symptoms of borderline personality. Thus, mediumship differed from DID in having better mental health and social adjustment, and a different clinical profile.

Self and identity in borderline personality disorder: Agency and mental time travel.

Science.gov (United States)

Gold, Natalie; Kyratsous, Michalis

2017-10-01

We consider how conceptions of the self and identity from the philosophical literature can help us to understand identity disturbance in borderline personality disorder (BPD). We present 3 philosophical approaches: connectedness, narrative, and agency. We show how these map on to 3 different ways in which the self can be temporally extended. The connectedness approach is dominant in philosophy, and the narrative approach has been used by psychiatry, but we argue that the lesser-known agency approach provides a promising way to theorize some aspects of identity disturbance in BPD. It relates the 2 diagnostic criteria of identity disturbance and disinhibition and is consistent with evidence of memory deficits and altered self-processing in BPD patients. © 2017 The Authors. Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

[Desire for amputation in body integrity identity disorder].

Science.gov (United States)

Blom, Rianne M; Hennekam, Raoul C M

2014-01-01

Body integrity identity disorder (BIID) is a rare neuropsychiatric disorder in which patients experience a mismatch between the real and experienced body from childhood. BIID results in a strong desire to amputate or paralyse one or more limbs. We describe two BIID patients. A 40-year-old healthy male suffered daily from his desire for amputation, and therefore made a request for amputation at our academic medical centre. A 61-year-old male proceeded to self-amputation to create the body he had wished for, thereby curing himself from BIID. To date, no treatment has been found for BIID. Therefore patients often proceed to self-amputation, which could lead to serious and even dangerous complications. These case histories suggest that elective amputation may be a treatment for BIID. Many doctors, however, will question the admissibility of amputation of a healthy limb.

[Body integrity identity disorder, relief after amputation].

Science.gov (United States)

Blom, R M; Braam, A W; de Boer-Kreeft, N; Sonnen, M P A M

2014-01-01

Body integrity identity disorder (BIID) is a rare condition in which a person, for no apparent physical reason, is tormented by the experience that a body-part, such as a limb, does not really belong to the body. Patients experience an intense desire for the limb to be amputated (a 'desire' formerly referred to as 'apotemnophilia'). We report on a 58-year-old male patient with BIID who froze one of his legs so that he could amputate it himself. A surgeon ultimately intervened and amputated the leg professionally. The patient was extremely relieved and was still experiencing relief at a follow-up three years later.

Trauma-related self-defining memories and future goals in Dissociative Identity Disorder.

Science.gov (United States)

Huntjens, Rafaële J C; Wessel, Ineke; Ostafin, Brian D; Boelen, Paul A; Behrens, Friederike; van Minnen, Agnes

2016-12-01

This study examined the content of self-defining autobiographical memories in different identities in patients with Dissociative Identity Disorder (DID) and comparison groups of patients with PTSD, healthy controls, and DID simulators. Consistent with the DID trauma model, analyses of objective ratings showed that DID patients in trauma identities retrieved more negative and trauma-related self-defining memories than DID patients in avoidant identities. Inconsistent with the DID trauma model, DID patients' self-rated trauma-relatedness of self-defining memories and future life goals did not differ between trauma identities and trauma avoidant identities. That is, the DID patients did not seem to be "shut off" from their trauma while in their avoidant identity. Furthermore, DID patients in both identities reported a higher proportion of avoidance goals compared to PTSD patients, with the latter group scoring comparably to healthy controls. The simulators behaved according to the instructions to respond differently in each identity (i.e., to report memories and goals consistent with the identity tested). The discrepant task behavior by DID patients and simulators indicated that DID patients did not seem to intentionally produce the hypothesized differences in performance between identities. In conclusion, for patients with DID (i.e., in both identities) and patients with PTSD, trauma played a central role in the retrieval of self-defining memories and in the formulation of life goals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is it Trauma- or Fantasy-based? Comparing dissociative identity disorder, post-traumatic stress disorder, simulators, and controls

NARCIS (Netherlands)

Vissia, E. M.; Giesen, M. E.; Chalavi, S.; Nijenhuis, E. R. S.; Draijer, N.; Brand, B. L.; Reinders, A. A. T. S.

Objective: The Trauma Model of dissociative identity disorder (DID) posits that DID is etiologically related to chronic neglect and physical and/or sexual abuse in childhood. In contrast, the Fantasy Model posits that DID can be simulated and is mediated by high suggestibility, fantasy proneness,

Gender identity disorder in a five-year-old boy.

OpenAIRE

Herman, S. P.

1983-01-01

Markedly effeminate behavior in a young boy is a source of concern and confusion for parents, teachers, and the child. It also represents a therapeutic dilemma for the child psychiatrist. The case of a five-year-old boy with gender identity disorder of childhood is presented and the literature on hypotheses of etiology, treatment, and long-term follow-up is reviewed. The ethical and philosophical questions posed by such a case are discussed.

Body integrity identity disorder and the ethics of mutilation.

OpenAIRE

Song, Robert

2013-01-01

The rare phenomenon in which a person desires amputation of a healthy limb, now often termed body integrity identity disorder, raises central questions for biomedical ethics. Standard bioethical discussions of surgical intervention in such cases fail to address the meaning of bodily integrity, which is intrinsic to a theological understanding of the goodness of the body. However, moral theological responses are liable to assume that such interventions necessarily represent an implicitly docet...

Body integrity identity disorder crosses culture: case reports in the Japanese and Chinese literature

NARCIS (Netherlands)

Blom, Rianne M.; Vulink, Nienke C.; van der Wal, Sija J.; Nakamae, Takashi; Tan, Zhonglin; Derks, Eske M.; Denys, Damiaan

2016-01-01

Body integrity identity disorder (BIID) is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only

Contextual Treatment of Dissociative Identity Disorder.

Science.gov (United States)

Gold, Steven N; Elhai, Jon D; Rea, Bayard D; Weiss, Donna; Masino, Theodore; Morris, Staci Leon; McIninch, Jessica

2001-01-01

Evidence for the effectiveness of contextual therapy, a new approach for treating adult survivors of prolonged child abuse (PCA), is provided via case studies of three women with Dissociative Identity Disorder (DID). Contextual therapy is based on the premise that it is not only traumatic experiences that account for PCA survivors' psychological difficulties. Even more fundamentally, many survivors grow up in an interpersonal context in which adequate resources for secure attachment and acquisition of adaptive living skills are not available. As a result, they are left with lasting deficits that undermine not only their current functioning, but also their ability to cope with reliving their traumatic memories in therapy. The primary focus of this treatment approach, therefore, is on developing capacities for feeling and functioning better in the present, rather than on extensive exploration and processing of the client's trauma history or, in the case of DID, of identity fragments. Treatment of the three cases presented ranged from eight months to two and one-half years' duration, and culminated in very positive outcomes. The women's reports of achievements, such as obtaining and maintaining gainful employment, greater self-sufficiency, and the establishment of more intimate and gratifying relationships, indicated marked improvements in daily functioning. Objective test data obtained at admission and discharge, and in one case, at follow-up, documented substantial reductions in dissociative, posttraumatic stress, depressive, and other symptoms.

Globular and disordered-the non-identical twins in protein-protein interactions

DEFF Research Database (Denmark)

Teilum, Kaare; Olsen, Johan Gotthardt; Kragelund, Birthe Brandt

2015-01-01

as a strong determinant for their function. This has fostered the notion that IDP's bind with low affinity but high specificity. Here we have analyzed available detailed thermodynamic data for protein-protein interactions to put to the test if the thermodynamic profiles of IDP interactions differ from those...... of other protein-protein interactions. We find that ordered proteins and the disordered ones act as non-identical twins operating by similar principles but where the disordered proteins complexes are on average less stable by 2.5 kcal mol(-1)....

Feminist identity as a predictor of eating disorder diagnostic status.

Science.gov (United States)

Green, Melinda A; Scott, Norman A; Riopel, Cori M; Skaggs, Anna K

2008-06-01

Passive Acceptance (PA) and Active Commitment (AC) subscales of the Feminist Identity Development Scale (FIDS) were examined as predictors of eating disorder diagnostic status as assessed by the Questionnaire for Eating Disorder Diagnoses (Q-EDD). Results of a hierarchical regression analysis revealed PA and AC scores were not statistically significant predictors of ED diagnostic status after controlling for diagnostic subtype. Results of a multiple regression analysis revealed FIDS as a statistically significant predictor of ED diagnostic status when failing to control for ED diagnostic subtype. Discrepancies suggest ED diagnostic subtype may serve as a moderator variable in the relationship between ED diagnostic status and FIDS. (c) 2008 Wiley Periodicals, Inc.

Beyond the Impasse – Reflections on Dissociative Identity Disorder from a Freudian–Lacanian Perspective

Directory of Open Access Journals (Sweden)

Reitske Meganck

2017-05-01

Full Text Available Dissociative identity disorder (DID is a widely contested diagnosis. The dominant posttraumatic model (PTM considers early life trauma to be the direct cause of the creation of alter identities and assumes that working directly with alter identities should be at the core of the therapeutic work. The socio-cognitive model, on the other hand, questions the validity of the DID diagnosis and proposes an iatrogenic origin of the disorder claiming that reigning therapeutic and socio-cultural discourses create and reify the problem. The author argues that looking at the underlying psychical dynamics can provide a way out of the debate on the veracity of the diagnosis. A structural conception of hysteria is presented to understand clinical and empirical observations on the prevalence, appearance and treatment of DID. On a more fundamental level, the concept of identification and the fundamental division of human psychic functioning are proposed as crucial for understanding the development and treatment of DID.

Beyond the Impasse – Reflections on Dissociative Identity Disorder from a Freudian–Lacanian Perspective

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Meganck, Reitske

2017-01-01

Dissociative identity disorder (DID) is a widely contested diagnosis. The dominant posttraumatic model (PTM) considers early life trauma to be the direct cause of the creation of alter identities and assumes that working directly with alter identities should be at the core of the therapeutic work. The socio-cognitive model, on the other hand, questions the validity of the DID diagnosis and proposes an iatrogenic origin of the disorder claiming that reigning therapeutic and socio-cultural discourses create and reify the problem. The author argues that looking at the underlying psychical dynamics can provide a way out of the debate on the veracity of the diagnosis. A structural conception of hysteria is presented to understand clinical and empirical observations on the prevalence, appearance and treatment of DID. On a more fundamental level, the concept of identification and the fundamental division of human psychic functioning are proposed as crucial for understanding the development and treatment of DID. PMID:28559875

Neural basis of limb ownership in individuals with body integrity identity disorder

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van Dijk, Milenna T.; van Wingen, Guido A.; van Lammeren, Anouk; Blom, Rianne M.; de Kwaasteniet, Bart P.; Scholte, H. Steven; Denys, Damiaan

2013-01-01

Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis

Clinical and theoretical parallels between desire for limb amputation and gender identity disorder.

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Lawrence, Anne A

2006-06-01

Desire for amputation of a healthy limb has usually been regarded as a paraphilia (apotemnophilia), but some researchers propose that it may be a disorder of identity, similar to Gender Identity Disorder (GID) or transsexualism. Similarities between the desire for limb amputation and nonhomosexual male-to-female (MtF) transsexualism include profound dissatisfaction with embodiment, related paraphilias from which the conditions plausibly derive (apotemnophilia and autogynephilia), sexual arousal from simulation of the sought-after status (pretending to be an amputee and transvestism), attraction to persons with the same body type one wants to acquire, and an elevated prevalence of other paraphilic interests. K. Freund and R. Blanchard (1993) proposed that nonhomosexual MtF transsexualism represents an erotic target location error, in which men whose preferred erotic targets are women also eroticize their own feminized bodies. Desire for limb amputation may also reflect an erotic target location error, occurring in combination with an unusual erotic target preference for amputees. This model predicts that persons who desire limb amputation would almost always be attracted to amputees and would display an increased prevalence of gender identity problems, both of which have been observed. Persons who desire limb amputation and nonhomosexual MtF transsexuals often assert that their motives for wanting to change their bodies reflect issues of identity rather than sexuality, but because erotic/romantic orientations contribute significantly to identity, such distinctions may not be meaningful. Experience with nonhomosexual MtF transsexualism suggests possible directions for research and treatment for persons who desire limb amputation.

Dissociative identity disorder: Medicolegal challenges.

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Farrell, Helen M

2011-01-01

Persons with dissociative identity disorder (DID) often present in the criminal justice system rather than the mental health system and perplex experts in both professions. DID is a controversial diagnosis with important medicolegal implications. Defendants have claimed that they committed serious crimes, including rape or murder, while they were in a dissociated state. Asserting that their alter personality committed the bad act, defendants have pleaded not guilty by reason of insanity (NGRI). In such instances, forensic experts are asked to assess the defendant for DID and provide testimony in court. Debate continues over whether DID truly exists, whether expert testimony should be allowed into evidence, and whether it should exculpate defendants for their criminal acts. This article reviews historical and theoretical perspectives on DID, presents cases that illustrate the legal implications and controversies of raising an insanity defense based on multiple personalities, and examines the role of forensic experts asked to comment on DID with the goal of assisting clinicians in the medicolegal assessment of DID in relation to crimes.

Merleau-Ponty's sexual schema and the sexual component of body integrity identity disorder.

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De Preester, Helena

2013-05-01

Body integrity identity disorder (BIID), formerly also known as apotemnophilia, is characterized by a desire for amputation of a healthy limb and is claimed to straddle or to even blur the boundary between psychiatry and neurology. The neurological line of approach, however, is a recent one, and is accompanied or preceded by psychodynamical, behavioural, philosophical, and psychiatric approaches and hypotheses. Next to its confusing history in which the disorder itself has no fixed identity and could not be classified under a specific discipline, its sexual component has been an issue of unclarity and controversy, and its assessment a criterion for distinguishing BIID from apotemnophilia, a paraphilia. Scholars referring to the lived body-a phenomenon primarily discussed in the phenomenological tradition in philosophy-seem willing to exclude the sexual component as inessential, whereas other authors notice important similarities with gender identity disorder or transsexualism, and thus precisely focus attention on the sexual component. This contribution outlines the history of BIID highlighting the vicissitudes of its sexual component, and questions the justification for distinguishing BIID from apotemnophilia and thus for omitting the sexual component as essential. Second, we explain a hardly discussed concept from Maurice Merleau-Ponty's Phenomenology of Perception (1945a), the sexual schema, and investigate how the sexual schema could function in interaction with the body image in an interpretation of BIID which starts from the lived body while giving the sexual component its due.

Circulating S100B and Adiponectin in Children Who Underwent Open Heart Surgery and Cardiopulmonary Bypass

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Alessandro Varrica

2015-01-01

Full Text Available Background. S100B protein, previously proposed as a consolidated marker of brain damage in congenital heart disease (CHD newborns who underwent cardiac surgery and cardiopulmonary bypass (CPB, has been progressively abandoned due to S100B CNS extra-source such as adipose tissue. The present study investigated CHD newborns, if adipose tissue contributes significantly to S100B serum levels. Methods. We conducted a prospective study in 26 CHD infants, without preexisting neurological disorders, who underwent cardiac surgery and CPB in whom blood samples for S100B and adiponectin (ADN measurement were drawn at five perioperative time-points. Results. S100B showed a significant increase from hospital admission up to 24 h after procedure reaching its maximum peak (P0.05 have been found all along perioperative monitoring. ADN/S100B ratio pattern was identical to S100B alone with the higher peak at the end of CPB and remained higher up to 24 h from surgery. Conclusions. The present study provides evidence that, in CHD infants, S100B protein is not affected by an extra-source adipose tissue release as suggested by no changes in circulating ADN concentrations.

[Persistent Perpetrator Contact in a Patient with Dissociative Identity Disorder].

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Tschöke, Stefan; Eisele, Frank; Steinert, Tilman

2016-05-01

The case of a young woman with still ongoing incest and forced prostitution is presented. The criteria for a dissociative identity disorder (DID) were met. Due to persistent contact to the perpetrator she was repeatedly revictimized. Based on the model of trauma-related dissociation we discuss to what extent she was capable of self-determined decision making as well as therapeutic consequences resulting therefrom. © Georg Thieme Verlag KG Stuttgart · New York.

Gender differences in workers with identical repetitive industrial tasks: exposure and musculoskeletal disorders.

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Nordander, Catarina; Ohlsson, Kerstina; Balogh, Istvan; Hansson, Gert-Ake; Axmon, Anna; Persson, Roger; Skerfving, Staffan

2008-08-01

For unknown reasons, females run a higher risk than males of work-related musculoskeletal disorders. The aim of this study was to evaluate whether male and female workers, with identical repetitive work tasks, differ concerning risk of disorders, physical or psychosocial exposures. Employees in two industries were studied; one rubber manufacturing and one mechanical assembly plant. These industries were selected since in both, large groups of males and females worked side by side performing identical repetitive work tasks. Physical exposure was measured by technical equipment. Postures and movements were registered by inclinometry for the head and upper arms, and by electrogoniometry for the wrists. Muscular activity (muscular rest and %max) was registered by surface electromyography for m. trapezius and the forearm extensors (18 males and 19 females). Psychosocial work environment was evaluated by the demand-control-support model (85 males and 138 females). Musculoskeletal disorders were assessed (105 males and 172 females), by interview (last 7-days complaints), and by physical examination (diagnoses). Concerning physical exposure, females showed higher muscular activity related to maximal voluntary contractions [(%MVE); m. trapezius: females 18 (SD 9.2), males 12 (SD 4.3); forearm extensors: females 39 (SD 11), males 27 (SD 10), right side, 90th percentile]. Working postures and movements were similar between genders. Also, concerning psychosocial work environment, no significant gender differences were found. Females had higher prevalences of disorders [complaints: age-adjusted prevalence odds ratio (POR) 2.3 (95% CI 1.3-3.8) for neck/shoulders, 2.4 (1.4-4.0) for elbows/hands; diagnoses: neck/shoulder 1.9 (1.1-3.6), elbows/hands 4.1 (1.2-9.3)]. In 225 workers, PORs were adjusted for household work, personal recovery and exercise, which only slightly affected the risk estimates. In identical work tasks, females showed substantially higher muscular activity in

Amputees by choice: body integrity identity disorder and the ethics of amputation.

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Bayne, Tim; Levy, Neil

2005-01-01

Should surgeons be permitted to amputate healthy limbs if patients request such operations? We argue that if such patients are experiencing significant distress as a consequence of the rare psychological disorder named Body Integrity Identity Disorder (BIID), such operations might be permissible. We examine rival accounts of the origins of the desire for healthy limb amputations and argue that none are as plausible as the BIID hypothesis. We then turn to the moral arguments against such operations, and argue that on the evidence available, none is compelling. BIID sufferers meet reasonable standards for rationality and autonomy: so as long as no other effective treatment for their disorder is available, surgeons ought to be allowed to accede to their requests.

The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

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Cohen-Kettenis, P.T.; Pfafflin, F.

2010-01-01

Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by

Identifying dissociative identity disorder: a self-report and projective study.

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Scroppo, J C; Drob, S L; Weinberger, J L; Eagle, P

1998-05-01

This study compared 21 female adult psychiatric patients diagnosed with dissociative identity disorder (DID) with 21 female adult nondissociative psychiatric patients to determine whether DID patients exhibit a distinguishing set of clinical features, and perceptual, attentional, and cognitive processes. Participants were assessed with the Dissociative Disorders Interview Schedule to assess diagnostic status. Group scores on the Dissociative Experiences Scale, Tellegen Absorption Scale, Childhood Trauma Questionnaire, Brief Symptom Inventory, and the Rorschach test were compared. DID participants reported earlier and more severe childhood trauma, more dissociative symptoms, and a greater propensity for altered states of consciousness. The DID participants also exhibited increased projective and imaginative activity, a diminished ability to integrate mental contents, a complex and driven cognitive style, and a highly unconventional view of reality.

Self-amputation of a healthy hand: a case of body integrity identity disorder.

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Sorene, E D; Heras-Palou, C; Burke, F D

2006-12-01

A case report is presented of self-amputation of a healthy hand. We have reviewed the literature and seek to broaden the scope of understanding of Body Integrity Identity Disorder. This rare condition can constitute a pitfall for the unsuspecting hand surgeon.

Children and adolescents with gender identity disorder referred to a pediatric medical center.

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Spack, Norman P; Edwards-Leeper, Laura; Feldman, Henry A; Leibowitz, Scott; Mandel, Francie; Diamond, David A; Vance, Stanley R

2012-03-01

To describe the patients with gender identity disorder referred to a pediatric medical center. We identify changes in patients after creation of the multidisciplinary Gender Management Service by expanding the Disorders of Sex Development clinic to include transgender patients. Data gathered on 97 consecutive patients gender behaviors, provided letters from current mental health professional, and parental support. Main descriptive measures included gender, age, Tanner stage, history of gender identity development, and psychiatric comorbidity. Genotypic male:female ratio was 43:54 (0.8:1); there was a slight preponderance of female patients but not significant from 1:1. Age of presentation was 14.8 ± 3.4 years (mean ± SD) without sex difference (P = .11). Tanner stage at presentation was 4.1 ± 1.4 for genotypic female patients and 3.6 ± 1.5 for genotypic male patients (P = .02). Age at start of medical treatment was 15.6 ± 2.8 years. Forty-three patients (44.3%) presented with significant psychiatric history, including 20 reporting self-mutilation (20.6%) and suicide attempts (9.3%). After establishment of a multidisciplinary gender clinic, the gender identity disorder population increased fourfold. Complex clinical presentations required additional mental health support as the patient population grew. Mean age and Tanner Stage were too advanced for pubertal suppressive therapy to be an affordable option for most patients. Two-thirds of patients were started on cross-sex hormone therapy. Greater awareness of the benefit of early medical intervention is needed. Psychological and physical effects of pubertal suppression and/or cross-sex hormones in our patients require further investigation.

Gender identity disorder: a literature review from a developmental perspective.

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Shechner, Tomer

2010-01-01

The present paper reviews the theoretical and empirical literature on children and adolescents with gender variant behaviors. The organizational framework underlying this review is one that presents gender behavior in children and adolescents as a continuum rather than as a dichotomy of normal versus abnormal categories. Seven domains are reviewed in relation to gender variant behavior in general, and to Gender Identity Disorder (GID) in particular: theories of normative gender development, phenomenology, prevalence, assessment, developmental trajectories, comorbidity and treatment.

Lay theories of gender identity disorder.

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Furnham, Adrian; Sen, Radhika

2013-01-01

This study examined lay theories regarding gender identity disorder (GID). Pilot interviews were completed with participants (n = 10) regarding their views on possible causes and treatments of GID. Participants (mainly young British people and students; n = 124) then completed a questionnaire that was based on the interviews and a review of the salient literature on lay theories. As hypothesized, participants believed most in biomedical causes and treatments of GID. Factor analysis (with varimax rotation) identified 4 factors in relation to causes of GID: upbringing and personal factors, pregnancy and brain abnormalities, environmental factors, and biomedical causes. Five factors that were identified in relation to the cure/treatment of GID were psychological assistance and personal factors, extreme medical and behavioral changes, alternative therapies, external factors, and medical treatments. The results indicated that participants neither agreed nor strongly disagreed about causes and cures regarding GID, but that these beliefs were logically related. Limitations, particularly of sampling, were considered.

Assessing the Utility of Diagnostic Criteria: A Multisite Study on Gender Identity Disorder

NARCIS (Netherlands)

Paap, M.C.S.; Kreukels, B.P.C.; Cohen-Kettenis, P.T.; Richter-Appelt, H.; De Cuypere, G.; Haraldsen, I.R.

2011-01-01

Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects of the

Dimensional profiles of male to female gender identity disorder: an exploratory research.

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Fisher, Alessandra D; Bandini, Elisa; Ricca, Valdo; Ferruccio, Naika; Corona, Giovanni; Meriggiola, Maria C; Jannini, Emmanuele A; Manieri, Chiara; Ristori, Jiska; Forti, Gianni; Mannucci, Edoardo; Maggi, Mario

2010-07-01

Male-to-Female Gender Identity Disorder (MtF GID) is a complex phenomenon that could be better evaluated by using a dimensional approach. To explore the aggregation of clinical manifestations of MtF GID in order to identify meaningful variables describing the heterogeneity of the disorder. A consecutive series of 80 MtF GID subjects (mean age 37 +/- 10.3 years), referred to the Interdepartmental Center for Assistance Gender Identity Disorder of Florence and to other Italian centers from July 2008 to June 2009, was studied. Diagnosis was based on formal psychiatric classification criteria. Factor analysis was performed. Several socio-demographic and clinical parameters were investigated. Patients were asked to complete the Bem Sex Role Inventory (BSRI, a self-rating scale to evaluate gender role) and Symptom Checklist-90 Revised (SCL-90-R, a self-rating scale to measure psychological state). Factor analysis identified two dimensional factors: Factor 1 was associated with sexual orientation, and Factor 2 related to behavioral and psychological correlates of early GID development. No correlation was observed between the two factors. A positive correlation between Factor 2 and feminine BSRI score was found, along with a negative correlation between Factor 2 and undifferentiated BSRI score. Moreover, a significant association between SCL-90-R Phobic subscale score and Factor 2 was observed. A variety of other socio-demographic parameters and clinical features were associated with both factors. Behavioral and psychological correlates of Factor 1 (sexual orientation) and Factor 2 (gender identity) do not constitute the framework of two separate clinical entities, but instead represent two dimensions of the complex MtF GID structure, which can be variably intertwined in the same subject. By using factor analysis, we offer a new approach capable of delineating a psychopathological and clinical profile of MtF GID patients.

Face identity recognition in autism spectrum disorders: a review of behavioral studies.

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Weigelt, Sarah; Koldewyn, Kami; Kanwisher, Nancy

2012-03-01

Face recognition--the ability to recognize a person from their facial appearance--is essential for normal social interaction. Face recognition deficits have been implicated in the most common disorder of social interaction: autism. Here we ask: is face identity recognition in fact impaired in people with autism? Reviewing behavioral studies we find no strong evidence for a qualitative difference in how facial identity is processed between those with and without autism: markers of typical face identity recognition, such as the face inversion effect, seem to be present in people with autism. However, quantitatively--i.e., how well facial identity is remembered or discriminated--people with autism perform worse than typical individuals. This impairment is particularly clear in face memory and in face perception tasks in which a delay intervenes between sample and test, and less so in tasks with no memory demand. Although some evidence suggests that this deficit may be specific to faces, further evidence on this question is necessary. Copyright © 2011 Elsevier Ltd. All rights reserved.

Meeting the Needs of Clients with Dissociative Identity Disorder: Considerations for Psychotherapy

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Ringrose, Jo L.

2011-01-01

Psychotherapy for clients with Dissociative Identity Disorder (DID) is different to therapy with most clients because these clients are multiple, comprising one or more host, and one or more alter personalities. The necessary components to be addressed in order that clients can live successfully either as a multiple or as an integrated person are…

Mental health service utilization for psychiatric disorders among Latinos living in the United States: the role of ethnic subgroup, ethnic identity, and language/social preferences.

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Keyes, K M; Martins, S S; Hatzenbuehler, M L; Blanco, C; Bates, L M; Hasin, Deborah S

2012-03-01

To examine aspects of Latino experience in the US as predicting service utilization for mood, anxiety, and substance disorders. Latino participants 18 and older in the NESARC (N = 6,359), a US national face to face survey. Outcomes were lifetime service utilization for DSM-IV lifetime mood/anxiety or substance disorders, diagnosed via structured interview (AUDADIS-IV). Main predictors were ethnic subgroup, ethnic identity, linguistic/social preferences, nativity/years in the US, and age at immigration. Higher levels of Latino ethnic identity and Spanish language/Latino social preferences predicted lower service utilization for mood disorders [ethnic identity OR = 0.52, language/social OR = 0.44] and anxiety disorders [ethnic identity OR = 0.67, language/social OR = 0.47], controlling for ethnic subgroup, disorder severity, time spent in the US, and economic and practical barriers Service utilization for alcohol/drug disorders was low across all Latino subgroups, without variation by examined predictors. Ethnic/cultural factors are strong determinants of service utilization for mood/anxiety, but not substance use disorders among Latinos in the US strategies to increase service utilization among Latinos with psychiatric disorders should be disorder specific, and recognize the role of ethnicity and identity as important components of a help-seeking model.

Mentalizing and interpersonal problems in borderline personality disorder: The mediating role of identity diffusion.

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De Meulemeester, Celine; Lowyck, Benedicte; Vermote, Rudi; Verhaest, Yannic; Luyten, Patrick

2017-12-01

Individuals with borderline personality disorder (BPD) are characterized by problems in interpersonal functioning and their long-term social integration often remains problematic. Extant theories have linked identity diffusion to many of the interpersonal problems characteristic of BPD patients. Recent theoretical accounts have suggested that identity diffusion results from problems with mentalizing or reflective functioning, that is, the capacity to understand oneself and others in terms of intentional mental states. In this study we tested these assumptions, i.e., whether identity diffusion plays a mediating role in the relationship between mentalizing difficulties and interpersonal problems, in a sample of 167 BPD patients. Highly significant correlations were found between mentalizing impairments, identity diffusion and interpersonal problems. Mediation analyses showed that identity diffusion fully mediated the relationship between mentalizing difficulties and interpersonal problems. This study provides preliminary evidence that impairments in mentalizing are related to identity diffusion, which in turn is related to interpersonal problems in BPD. Further longitudinal research is needed to further substantiate these conclusions. Copyright © 2017 Elsevier B.V. All rights reserved.

Gender identity outcomes in children with disorders/differences of sex development: Predictive factors.

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Bakula, Dana M; Mullins, Alexandria J; Sharkey, Christina M; Wolfe-Christensen, Cortney; Mullins, Larry L; Wisniewski, Amy B

2017-06-01

Disorders/differences of sex development (DSD) comprise multiple congenital conditions in which chromosomal, gonadal, and/or anatomical sex are discordant. The prediction of future gender identity (i.e., self-identifying as male, female, or other) in children with DSD can be imprecise, and current knowledge about the development of gender identity in people with, and without DSD, is limited. However, sex of rearing is the strongest predictor of gender identity for the majority of individuals with various DSD conditions. When making decisions regarding sex of rearing biological factors (e.g., possession of a Y chromosome, degree and duration of pre- and postnatal androgen exposure, phenotypic presentation of the external genitalia, and fertility potential), social and cultural factors, as well as quality of life should be considered. Information on gender identity outcomes across a range of DSD diagnoses is presented to aid in sex of rearing assignment. Copyright © 2017 Elsevier Inc. All rights reserved.

Simulation of multiple personalities: a review of research comparing diagnosed and simulated dissociative identity disorder.

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Boysen, Guy A; VanBergen, Alexandra

2014-02-01

Dissociative Identity Disorder (DID) has long been surrounded by controversy due to disagreement about its etiology and the validity of its associated phenomena. Researchers have conducted studies comparing people diagnosed with DID and people simulating DID in order to better understand the disorder. The current research presents a systematic review of this DID simulation research. The literature consists of 20 studies and contains several replicated findings. Replicated differences between the groups include symptom presentation, identity presentation, and cognitive processing deficits. Replicated similarities between the groups include interidentity transfer of information as shown by measures of recall, recognition, and priming. Despite some consistent findings, this research literature is hindered by methodological flaws that reduce experimental validity. Copyright © 2013 Elsevier Ltd. All rights reserved.

Gender identity disorder: treatment and post-transition care in transsexual adults.

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Jain, A; Bradbeer, C

2007-03-01

As sex reassignment surgeries become more common and advanced, health professionals are more likely to see patients with gender identity disorders (GID) in their clinics. This can be challenging in many ways, and the challenges continue even after gender reassignment surgery as each case may present with unique anatomy. This article reviews the definition and treatment of GID, service provision in National Health Service and post-transition care of such patients.

Body integrity identity disorder beyond amputation: consent and liberty.

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White, Amy

2014-09-01

In this article, I argue that persons suffering from Body Integrity Identity Disorder (BIID) can give informed consent to surgical measures designed to treat this disorder. This is true even if the surgery seems radical or irrational to most people. The decision to have surgery made by a BIID patient is not necessarily coerced, incompetent or uninformed. If surgery for BIID is offered, there should certainly be a screening process in place to insure informed consent. It is beyond the scope of this work, however, to define all the conditions that should be placed on the availability of surgery. However, I argue, given the similarities between BIID and gender dysphoria and the success of such gatekeeping measures for the surgical treatment of gender dysphoria, it is reasonable that similar conditions be in place for BIID. Once other treatment options are tried and gatekeeping measures satisfied, A BIID patient can give informed consent to radical surgery.

Gender identity in disorders of sex development: review article.

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Yang, Jennifer H; Baskin, Laurence S; DiSandro, Michael

2010-01-01

Many concerns have been raised regarding the treatment and long-term outcome of infants born with complex genital anomalies. Debate among clinicians, psychologists, ethicists, and patient advocate groups regarding the optimal management of these individuals is ongoing. Although determining the most appropriate gender is a difficult task, this review will help clarify some of the issues at hand. A literature review which addresses the challenges of advising families about gender identity in infants and children with disorders of sex development. The evidence for endocrine effects on neurobiological development with regard to sexual behavior is compelling, although the existing outcome studies are largely anecdotal and somewhat contradictory. Gender assignment in infants born with a disorder of sex development remains only one of the many difficult decisions faced by both the treatment team and the family. Improved long-term follow-up of these patients will provide much needed feedback on previous and contemporary management. 2010 Elsevier Inc. All rights reserved.

Adapting Dialectical Behavior Therapy for the Treatment of Dissociative Identity Disorder.

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Foote, Brad; Van Orden, Kim

2016-12-31

Dialectical Behavior Therapy (DBT), created by Marsha Linehan, has been shown to be an effective therapy for the treatment of borderline personality disorder (BPD) and for suicidal and self-harming behavior. Dissociative identity disorder (DID) is a complex post-traumatic disorder which is highly comorbid with BPD, shares a number of clinical features with BPD, and which like BPD features a high degree of suicidality. The DID treatment literature emphasizes the importance of a staged approach, beginning with the creation of a safe therapeutic frame prior to addressing traumatic material; DBT is also a staged treatment, in which behavioral and safety issues are addressed in Stage 1, and trauma work reserved for Stage 2. The authors describe adapting DBT, and especially its techniques for Stage 1 safety work, for work with DID patients. Basic theoretical principles are described and illustrated with a case example.

Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition

OpenAIRE

Adriana Santos, Carla; Fonseca, Jorge; Brito, José; Fernandes, Tânia; Gonçalves, Luísa; Sousa Guerreiro, António

2014-01-01

Background and aims: Dysphagic patients who underwent endoscopic gastrostomy (PEG) usually present protein-energy malnutrition, but little is known about micronutrient malnutrition. The aim of the present study was the evaluation of serum zinc in patients who underwent endoscopic gastrostomy and its relationship with serum proteins, whole blood zinc, and the nature of underlying disorder. Methods: From patients that underwent gastrostomy a blood sample was obtained minutes before the procedur...

Reduced Reliance on Optimal Facial Information for Identity Recognition in Autism Spectrum Disorder

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Leonard, Hayley C.; Annaz, Dagmara; Karmiloff-Smith, Annette; Johnson, Mark H.

2013-01-01

Previous research into face processing in autism spectrum disorder (ASD) has revealed atypical biases toward particular facial information during identity recognition. Specifically, a focus on features (or high spatial frequencies [HSFs]) has been reported for both face and nonface processing in ASD. The current study investigated the development…

Dysfunctional Career Thoughts and Attitudes as Predictors of Vocational Identity among Young Adults with Attention Deficit Hyperactivity Disorder

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Dipeolu, Abiola; Sniatecki, Jessica L.; Storlie, Cassandra A.; Hargrave, Stephanie

2013-01-01

This study examined dysfunctional career thoughts and attitudes as predictors of vocational identity among high school students with Attention Deficit Hyperactivity Disorder (ADHD). Regression analysis results indicated that dysfunctional career thoughts and attitudes were significant predictors of vocational identity, accounting for 42% of the…

Globular and disordered – the non-identical twins in protein-protein interactions

Directory of Open Access Journals (Sweden)

Kaare eTeilum

2015-07-01

Full Text Available In biology proteins from different structural classes interact across and within classes in ways that are optimized to achieve balanced functional outputs. The interactions between intrinsically disordered proteins (IDPs and other proteins rely on changes in flexibility and this is seen as a strong determinant for their function. This has fostered the notion that IDP’s bind with low affinity but high specificity. Here we have analyzed available detailed thermodynamic data for protein-protein interactions to put to the test if the thermodynamic profiles of IDP interactions differ from those of other protein-protein interactions. We find that ordered proteins and the disordered ones act as non identical twins operating by similar principles but where the disordered proteins complexes are on average less stable by 2.5 kcal mol-1.

Attention to Social Stimuli and Facial Identity Recognition Skills in Autism Spectrum Disorder

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Wilson, C. E.; Brock, J.; Palermo, R.

2010-01-01

Background: Previous research suggests that individuals with autism spectrum disorder (ASD) have a reduced preference for viewing social stimuli in the environment and impaired facial identity recognition. Methods: Here, we directly tested a link between these two phenomena in 13 ASD children and 13 age-matched typically developing (TD) controls.…

Dissociative Identity Disorder CPAP Adherence: An Uncommon Factor in Obstructive Sleep Apnea.

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Gandotra, Kamal; Golish, Joseph; Rosenberg, Carl; Strohl, Kingman

2018-04-15

We present a case of a patient with dissociative identity disorder and symptomatic sleep apnea who was treated with continuous positive airway pressure (CPAP). CPAP use depended upon which personality the patient exhibited but apnea reduction did not. This case illustrates in one individual how personality can positively or negatively affect CPAP adherence. © 2018 American Academy of Sleep Medicine.

Gender identity disorder: general overview and surgical treatment for vaginoplasty in male-to-female transsexuals.

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Selvaggi, Gennaro; Ceulemans, Peter; De Cuypere, Griet; VanLanduyt, Koen; Blondeel, Phillip; Hamdi, Moustapha; Bowman, Cameron; Monstrey, Stan

2005-11-01

After studying this article, the participant should be able to discuss: 1. The terminology related to male-to-female gender dysphoria. 2. The different theories regarding cause, epidemiology, and treatment of gender dysphoria. 3. The surgical goals of sex reassignment surgery in male-to-female transsexualism. 4. The surgical techniques available for sex reassignment surgery in male-to-female transsexualism. Gender identity disorder (previously "transsexualism") is the term used for individuals who show a strong and persistent cross-gender identification and a persistent discomfort with their anatomical sex, as manifested by a preoccupation with getting rid of one's sex characteristics, or the belief of being born in the wrong sex. Since 1978, the Harry Benjamin International Gender Dysphoria Association (in honor of Dr. Harry Benjamin, one of the first physicians who made many clinicians aware of the potential benefits of sex reassignment surgery) has played a major role in the research and treatment of gender identity disorder, publishing the Standards of Care for Gender Dysphoric Persons. The authors performed an overview of the terminology related to male-to-female gender identity disorder; the different theories regarding cause, epidemiology, and treatment; the goals expected; and the surgical technique available for sex reassignment surgery in male-to-female transsexualism. Surgical techniques available for sex reassignment surgery in male-to-female transsexualism, with advantages and disadvantages offered by each technique, are reviewed. Other feminizing nongenital operative interventions are also examined. This review describes recent etiopathogenetic theories and actual guidelines on the treatment of the gender identity disorder in male-to-female transsexuals; the penile-scrotal skin flap technique is considered the state of the art for vaginoplasty in male-to-female transsexuals, whereas other techniques (rectosigmoid flap, local flaps, and isolated skin

Assessing the utility of diagnostic criteria: a multi-site study on gender identity disorder

NARCIS (Netherlands)

Paap, Muirne; Kreukels, Baudewijntje P.C.; Cohen-Kettenis, Peggy; Richter-Appelt, Hertha; De Cuypere, Griet; Haraldsen, Ira R.

2011-01-01

Introduction: Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects

Limb amputations in fixed dystonia: a form of body integrity identity disorder?

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Edwards, Mark J; Alonso-Canovas, Araceli; Schrag, Arnette; Bloem, Bastiaan R; Thompson, Philip D; Bhatia, Kailash

2011-07-01

Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases, combined with recent data regarding disorders of mental rotation in patients with fixed dystonia, as well as previous data regarding body integrity identity disorder and amputations sought by patients with chronic regional pain syndrome, raise the possibility that patients with fixed dystonia might have a deficit in body schema that predisposes them to developing fixed dystonia and drives some to seek amputation. The outcome of amputation in fixed dystonia is invariably unfavorable. Copyright © 2011 Movement Disorder Society.

Non-suicidal self-injury in patients with eating disorder: associations with identity formation above and beyond anxiety and depression.

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Claes, Laurence; Luyckx, Koen; Bijttebier, Patricia; Turner, Brianna; Ghandi, Amarendra; Smets, Jos; Norre, Jan; Van Assche, Leen; Verheyen, Els; Goris, Yvienne; Hoksbergen, Ingrid; Schoevaerts, Katrien

2015-03-01

In the present study, we investigated the association between non-suicidal self-injury (NSSI) and problems in identity formation among patients with eating disorder (ED). NSSI is highly prevalent in ED, and problems with identity formation are characteristic of both NSSI and ED. Few studies, however, have investigated identity formation in patients with ED with and without NSSI while taking into account comorbid psychopathology (e.g. anxiety and depression). Therefore, we investigated the relationships between NSSI characteristics, identity confusion/synthesis, and anxiety/depression in 99 female patients with ED by means of self-report questionnaires. The results showed that 58.6% of the patients with ED engaged in at least one type of NSSI (most frequently cutting), with no significant differences in rates of NSSI or identity problems among ED subtypes. Presence, versatility and automatic negative reinforcement functions of NSSI were each significantly and positively related to identity confusion and negatively related to identity synthesis. Even after controlling for age, anxiety, and depression, lack of identity synthesis remained a significant predictor of NSSI in patients with ED. Given that NSSI may constitute an effort to deal with identity confusion/synthesis in patients with ED, therapists should take this developmental task into account while treating patients with ED with NSSI. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Face Processing in Children with Autism Spectrum Disorder: Independent or Interactive Processing of Facial Identity and Facial Expression?

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Krebs, Julia F.; Biswas, Ajanta; Pascalis, Olivier; Kamp-Becker, Inge; Remschmidt, Helmuth; Schwarzer, Gudrun

2011-01-01

The current study investigated if deficits in processing emotional expression affect facial identity processing and vice versa in children with autism spectrum disorder. Children with autism and IQ and age matched typically developing children classified faces either by emotional expression, thereby ignoring facial identity or by facial identity…

Voluntary switching between identities in dissociative identity disorder: A functional MRI case study.

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Savoy, R L; Frederick, B B; Keuroghlian, A S; Wolk, P C

2012-01-01

Patients who suffer from dissociative identity disorder present unique scientific and clinical challenges for psychology and psychiatry. We have been fortunate in working with a patient who-while undergoing functional MRI-can switch rapidly and voluntarily between her main personality (a middle-aged, high-functioning woman) and an alternate personality (a 4-6-year-old girl). A unique task was designed to isolate the processes occurring during the switches between these personalities. Data are from two imaging sessions, conducted months apart, each showing the same activated areas during switches between these personalities. The activated areas include the following: the primary sensory and motor cortex, likely associated with characteristic facial movements made during switching; the nucleus accumbens bilaterally, possibly associated with aspects of reward connected with switching; and prefrontal sites, presumably associated with the executive control involved in the switching of personalities.

The body as a simulacrum of identity: the subjective experience in the eating disorders

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Patrizia Brogna

2010-12-01

Full Text Available This study aims at better understanding the subjective experience, the so-called Erlebnis, in individuals diagnosed with Eating Disorders (ED. We shall highlight the particular way in which people with such disorders perceive their own bodies and specifically how they perceive their bodies in the presence of other people. To this end we shall analyze the subjective experience by means of two concepts as described by French philosopher Jean-Paul Sartre: "body-self" and "body-forothers". Our hypothesis is that some people suffering from eating disorders, especially those with a diagnosis of Eating Disorders Not Otherwise Specified (EDNOS, experience their body mainly as body-for-others. Rather than a diagnostic category, EDNOS could be conceived as an anthropological configuration vulnerable to ED. Eating disorders appear as an "identity disorder" characterized by a suspension of the experiential polarity between self and other-than-self.

Mothers of boys with gender identity disorder: a comparison of matched controls.

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Marantz, S; Coates, S

1991-03-01

This pilot study compared mothers of boys with gender identity disorder (GID) with mothers of normal boys to determine whether differences in psychopathology and child-rearing attitudes and practices could be identified. Results of the Diagnostic Interview for Borderlines and the Beck Depression Inventory revealed that mothers of boys with GID had more symptoms of depression and more often met the criteria for Borderline Personality Disorder than the controls. Fifty-three percent of the mothers of boys with GID compared with only 6% of controls met the diagnosis for Borderline Personality Disorder on the Diagnostic Interview for Borderlines or had symptoms of depression on the Beck Depression Inventory. Results of the Summers and Walsh Symbiosis Scale suggested that mothers of probands had child-rearing attitudes and practices that encouraged symbiosis and discouraged the development of autonomy.

Identity disorder and social-psychological adaptation in patients with hepatobiliary disease

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V. V. Khramtsova

2017-12-01

Full Text Available Negative bodily experience due to health complications and disability is perceived as a difficult life situation. The success of adaptation, commitment to treatment and cooperation with a doctor depend on the personality characteristics that define behavioral representations. Aim. Investigate the structure of identity and mechanisms of social-psychological adaptation of patients with the hepatobiliary system disease. Contingent and methods. 75 patients with a diffuse liver disease - chronic hepatitis, mostly of viral etiology (36 people and liver cirrhosis (39 patients have been examined. We have applied clinical, clinical-psychological, mathematical and empirical methods, semi-structured cross-interviews ("patient-doctor", "patient-psychologist", diagnostics of personal characteristics, identity structure, social-psychological components of adaptation. Three leading personality profiles have been highlighted. Results. Persons with a disharmonious personality development are characterized by disorders in the area of identity formation and development. Fragmentation, the impossibility of personal integration and severe penetrability from the environment contribute to social-psychological maladjustment. The coping is aimed at preserving the problem situation and intensifying the intrapersonal conflict. For persons with difficulties in the adaptation of the personality, a violation of activity interaction with the surrounding world is characteristic, a ban on one's self-identity. Social adaptation is often disrupted due to instability in the emotional-volitional sphere and choosing low-adaptive coping strategies. Genuine "I" and identity formation is impeded for the individuals suppressing aggressive impulses. Adaptability tends to be discrete. With mental stress increasing, the likelihood of choosing low-adaptive coping strategies increases. Conclusions. When drafting psycho-correction programs and medical treatment of people with a hepatobiliary

Three cases of dissociative identity disorder and co-occurring borderline personality disorder treated with dynamic deconstructive psychotherapy.

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Chlebowski, Susan M; Gregory, Robert J

2012-01-01

Dissociative Identity Disorder (DID) is an under-researched entity and there are no clinical trials employing manual-based therapies and validated outcome measures. There is evidence that borderline personality disorder (BPD) commonly co-occurs with DID and can worsen its course. The authors report three cases of DID with co-occurring BPD that we successfully treated with a manual-based treatment, Dynamic Deconstructive Psychotherapy (DDP). Each of the three clients achieved a 34% to 79% reduction in their Dissociative Experiences Scale scores within 12 months of initiating therapy. Dynamic Deconstructive Psychotherapy was developed for treatment refractory BPD and differs in some respects from expert consensus treatment of DID. It may be a promising modality for DID complicated by co-occurring BPD.

Meet Dr Jekyll: a case of a psychiatrist with dissociative identity disorder.

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Suetani, Shuichi; Markwick, Elizabeth

2014-10-01

Dissociative identity disorder (DID) is a controversial psychiatric diagnosis. This case review presents a retired psychiatrist with a history of DID. This case is used to illustrate current thinking about the characteristics and aetiology of DID. It also argues for the importance of being aware of both our personal and professional biases in our own clinical practice. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Out of mind - out of sight : studies on clinical and psychophysiological characteristics of dissociative identity disorder

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Dale, Karl Yngvar

2008-01-01

Dissociative identity disorder (DID; APA, 1994), previously labeled Multiple personality (APA, 1980) and Multiple Personality Disorder (APA, 1987), has good diagnostic validity (Gleaves, May, & Cardeña, 2001) and is supported by taxometric research, whereby two types of dissociation have been identified: Pathological dissociation, whose features are consistent with DID, and nonpathological dissociation (Waller, Putnam, & Carlson, 1996). On these grounds, we aimed to contribute to a further...

Dissociation and psychosis in dissociative identity disorder and schizophrenia.

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Laddis, Andreas; Dell, Paul F

2012-01-01

Dissociative symptoms, first-rank symptoms of schizophrenia, and delusions were assessed in 40 schizophrenia patients and 40 dissociative identity disorder (DID) patients with the Multidimensional Inventory of Dissociation (MID). Schizophrenia patients were diagnosed with the Structured Clinical Interview for the DSM-IV Axis I Disorders; DID patients were diagnosed with the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised. DID patients obtained significantly (a) higher dissociation scores; (b) higher passive-influence scores (first-rank symptoms); and (c) higher scores on scales that measure child voices, angry voices, persecutory voices, voices arguing, and voices commenting. Schizophrenia patients obtained significantly higher delusion scores than did DID patients. What is odd is that the dissociation scores of schizophrenia patients were unrelated to their reports of childhood maltreatment. Multiple regression analyses indicated that 81% of the variance in DID patients' dissociation scores was predicted by the MID's Ego-Alien Experiences Scale, whereas 92% of the variance in schizophrenia patients' dissociation scores was predicted by the MID's Voices Scale. We propose that schizophrenia patients' responses to the MID do not index the same pathology as do the responses of DID patients. We argue that neither phenomenological definitions of dissociation nor the current generation of dissociation instruments (which are uniformly phenomenological in nature) can distinguish between the dissociative phenomena of DID and what we suspect are just the dissociation-like phenomena of schizophrenia.

[Body Integrity Identity Disorder (BIID): interrogation of patients and theories for explanation].

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Kasten, E

2009-01-01

Apotemnophilia, Amputee Identity Disorder or Body Integrity Identity Disorder (BIID) is the intensive feeling that the body will be "more complete" after amputation of a limb. The article disputes the question of matching personality characteristics of these subjects and asks for motives. Based on reports of nine individuals, triggering experiences are referred. In contrast to other children, often these subjects were fascinated by the sight of a handicapped person. In the article is investigated, whether the concerned limb showed more affections. Described is typical pretending behavior. Parallels to body dysmorphic disorder (BDD), fetishism, or delusions are investigated. These were minor, in most cases the wish was fixated on a specific limb, the subjects were aware of the abnormity of their desire and quarreled with the pros and cons. Sexual motives were found in one third. Some of the interviewed persons were in medical or psychological therapy; this did not let the desire disappear. In several BIID sufferers the wish for amputation changed, e. g. from the left to the right leg. This finding is not in accordance with the brain-dysfunction-theory. These people rather have an ideal of a "perfect" body minus one arm or leg. Most admire the beauty of a stump, and see amputees as "heroes" who still master their life in spite of their handicap. BIID is not a homogenous disturbance, one should separate three axes: 1. Strength of neuronal dysfunction, 2. Psychic components (e. g. secondary morbid gain) and 3. Intensity of sexual interests.

Gender identity disorder. Is this a potentially fatal condition?

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Yousafzai, Abdul Wahab; Bhutto, Naila

2007-01-01

A person with a Gender Identity Disorder (GID) is a person who strongly identifies with the other sex. The individual may identify with the opposite sex to the point of believing that he/she is, in fact, a member of the other sex who is trapped in the wrong body. The treatment option is sex reassignment surgery. In Pakistan There is no specialized facility sex reassignment surgery. This case report deals with possible serious outcome of GID in Pakistan as a result of castration procedure which is carried out by 'gurus' in Pakistan. A systemic research in our country to this effect is required to find out the outcome of GID in Pakistan.

The DSM diagnostic criteria for gender identity disorder in children.

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Zucker, Kenneth J

2010-04-01

In this article, I review the diagnostic criteria for Gender Identity Disorder (GID) in children as they were formulated in the DSM-III, DSM-III-R, and DSM-IV. The article focuses on the cumulative evidence for diagnostic reliability and validity. It does not address the broader conceptual discussion regarding GID as "disorder," as this issue is addressed in a companion article by Meyer-Bahlburg (2009). This article addresses criticisms of the GID criteria for children which, in my view, can be addressed by extant empirical data. Based in part on reanalysis of data, I conclude that the persistent desire to be of the other gender should, in contrast to DSM-IV, be a necessary symptom for the diagnosis. If anything, this would result in a tightening of the diagnostic criteria and may result in a better separation of children with GID from children who display marked gender variance, but without the desire to be of the other gender.

'Everyone here wants everyone else to get better': The role of social identity in eating disorder recovery.

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McNamara, Niamh; Parsons, Harriet

2016-12-01

Retention of a positively valued illness identity contributes to poor outcomes for individuals with eating disorders (EDs). Consequently, dis-identification from the illness identity and the adoption of a recovery identity are vital for successful recovery. While social identity processes have been shown to influence ED maintenance, their role in recovery is rarely considered. This study explores how a sense of shared identity helps individuals with EDs manage their condition and promotes recovery. Transcripts from 18 online support sessions involving 75 participants were thematically analysed. Our findings suggest that the illness identity initially operates as a social identity that forms the basis for connections with similar others. For those wishing to recover, identity-based support is then perceived to be more effective than that found outside the group. Online interactions also facilitate construction of a new shared recovery identity which promotes a shift from the illness identity as a primary source of definition and endorses group norms of illness disclosure and treatment engagement. While in the clinical literature, ED identity is seen as problematic and interventions are targeted at challenging an individual's self-concept, we suggest that interventions could instead harness identity resources to support a transition to a recovery identity. © 2016 The British Psychological Society.

Interidentity amnesia in dissociative identity disorder.

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Morton, John

2017-07-01

Patients diagnosed with dissociative identity disorder (DID) usually present with alternative personality states (alters) who take separate control of consciousness. Commonly, one alter will claim they have no awareness of events which took place when another alter was in control. However, some kinds of material are transferred across the alter boundary. Huntjens et al. devised an objective method of demonstrating such transfer. In the main study, following Huntjens et al., for three patients, two alters were taught different sets of nouns. The following week, one of the alters was given a recognition memory test including both sets plus distractor words. The patients in the Huntjens experiment responded in the same way to words in both sets. In the present experiemnt, two of the patients tested had pairs of alters where there was no interference from the material which was presented to the other alter. In one of these cases, there was breakthrough with one pairing of alters, a pattern matched in a subsidiary experiment. The population of individuals with DID are not homogeneous with respect to the depth of the blocking of episodic material from one alter to another.

A review of published research on adult dissociative identity disorder: 2000-2010.

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Boysen, Guy A; VanBergen, Alexandra

2013-01-01

The purpose of this study was to assess the scientific and etiological status of dissociative identity disorder (DID) by examining cases published from 2000 to 2010. In terms of scientific status, DID is a small but ongoing field of study. The review yielded 21 case studies and 80 empirical studies, presenting data on 1171 new cases of DID. A mean of 9 articles, each containing a mean of 17 new cases of DID, emerged each year. In terms of etiological status, many of the central criticisms of the disorder's validity remain unaddressed. Most cases of DID emerged from a small number of countries and clinicians. In addition, documented cases occurring outside treatment were almost nonexistent. Finally, people simulating DID in the laboratory were mostly indistinguishable from individuals with DID. Overall, DID is still a topic of study, but the research lacks the productivity and focus needed to resolve ongoing controversies surrounding the disorder.

Identity development in adolescents with mental problems.

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Jung, Emanuel; Pick, Oliver; Schlüter-Müller, Susanne; Schmeck, Klaus; Goth, Kirstin

2013-07-31

In the revision of the Diagnostic and Statistical Manual (DSM-5), "Identity" is an essential diagnostic criterion for personality disorders (self-related personality functioning) in the alternative approach to the diagnosis of personality disorders in Section III of DSM-5. Integrating a broad range of established identity concepts, AIDA (Assessment of Identity Development in Adolescence) is a new questionnaire to assess pathology-related identity development in healthy and disturbed adolescents aged 12 to 18 years. Aim of the present study is to investigate differences in identity development between adolescents with different psychiatric diagnoses. Participants were 86 adolescent psychiatric in- and outpatients aged 12 to 18 years. The test set includes the questionnaire AIDA and two semi-structured psychiatric interviews (SCID-II, K-DIPS). The patients were assigned to three diagnostic groups (personality disorders, internalizing disorders, externalizing disorders). Differences were analyzed by multivariate analysis of variance MANOVA. In line with our hypotheses, patients with personality disorders showed the highest scores in all AIDA scales with T>70. Patients with externalizing disorders showed scores in an average range compared to population norms, while patients with internalizing disorders lay in between with scores around T=60. The AIDA total score was highly significant between the groups with a remarkable effect size of f= 0.44. Impairment of identity development differs between adolescent patients with different forms of mental disorders. The AIDA questionnaire is able to discriminate between these groups. This may help to improve assessment and treatment of adolescents with severe psychiatric problems.

Puberty suppression in gender identity disorder: the Amsterdam experience.

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Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T

2011-05-17

The use of gonadotropin-releasing hormone analogs (GnRHa) to suppress puberty in adolescents with gender dysphoria is a fairly new intervention in the field of gender identity disorders or transsexualism. GnRHa are used to give adolescents time to make balanced decisions on any further treatment steps, and to obtain improved results in the physical appearance of those who opt to continue with sex reassignment. The effects of GnRHa are reversible. However, concerns have been raised about the risk of making the wrong treatment decisions, as gender identity could fluctuate during adolescence, adolescents in general might have poor decision-making abilities, and there are potential adverse effects on health and on psychological and psychosexual functioning. Proponents of puberty suppression emphasize the beneficial effects of GnRHa on the adolescents' mental health, quality of life and of having a physical appearance that makes it possible for the patients to live unobtrusively in their desired gender role. In this Review, we discuss the evidence pertaining to the debate on the effects of GnRHa treatment. From the studies that have been published thus far, it seems that the benefits outweigh the risks. However, more systematic research in this area is needed to determine the safety of this approach.

Sexual orientation, gender identity, and romantic relationships in adolescents and adults with Autism Spectrum Disorder

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Dewinter, J.; De Graaf, H.; Begeer, S.

2017-01-01

This study compared sexual orientation and romantic relationship experience in a large sample of adolescents and adults with autism spectrum disorder (ASD) (n = 675) and general population peers (n = 8064). Gender identity was explored in the ASD group in relation to assigned gender at birth.

Assessment of genuine and simulated dissociative identity disorder on the structured interview of reported symptoms.

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Brand, Bethany L; McNary, Scot W; Loewenstein, Richard J; Kolos, Amie C; Barr, Stefanie R

2006-01-01

Little is known about how to detect malingered dissociative identity disorder (DID). This study presents preliminary data from an ongoing study about the performance of DID patients on the Structured Interview of Reported Symptoms (SIRS, Rogers, Bagby, & Dickens, 1992), considered to be a "gold standard" structured interview in forensic psychology to detect feigning of psychological symptoms. Test responses from 20 dissociative identity disorder (DID) patients are compared to those of 43 well informed and motivated DID simulators. Both the simulators and DID patients endorsed such a high number of symptoms that their average overall scores would typically be interpreted as indicative of feigning. The simulators' mean scores were significantly higher than those of the DID patients on only four out of 13 scales. These results provide preliminary evidence that well informed and motivated simulators are able to fairly successfully simulate DID patients and avoid detection on the SIRS. Furthermore, many DID patients may be at risk for being inaccurately labeled as feigning on the SIRS.

The DSM Diagnostic Criteria for Gender Identity Disorder in Adolescents and Adults

OpenAIRE

Cohen-Kettenis, P.T.; Pfafflin, F.

2010-01-01

Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by similarities and differences of the terms transsexualism and GID, the inability of the current criteria to capture the whole spectrum of gender variance phenomena, the potential risk of unnecessar...

Neural Basis of Limb Ownership in Individuals with Body Integrity Identity Disorder

OpenAIRE

van Dijk, Milenna T.; van Wingen, Guido A.; van Lammeren, Anouk; Blom, Rianne M.; de Kwaasteniet, Bart P.; Scholte, H. Steven; Denys, Damiaan

2013-01-01

Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs ...

Comparison of Masculine and Feminine Gender Roles in Iranian Patients with Gender Identity Disorder

Directory of Open Access Journals (Sweden)

Kaveh Alavi, MD

2015-12-01

Conclusion: Iranian FM‐GID individuals were less feminine than normal men. However, MF‐GID individuals were similar to normal women or more feminine. Cultural considerations remain to be investigated. Alavi K, Eftekhar M and Jalali Nadoushan AH. Comparison of masculine and feminine gender roles in Iranian patients with gender identity disorder. Sex Med 2015;3:261–268.

Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder : A Controlled fMRI Perfusion Study

NARCIS (Netherlands)

Schlumpf, Yolanda R.; Reinders, Antje A. T. S.; Nijenhuis, Ellert R. S.; Luechinger, Roger; van Osch, Matthias J. P.; Jaencke, Lutz

2014-01-01

Background: In accordance with the Theory of Structural Dissociation of the Personality (TSDP), studies of dissociative identity disorder (DID) have documented that two prototypical dissociative subsystems of the personality, the "Emotional Part'' (EP) and the "Apparently Normal Part'' (ANP), have

Evidence for phase-based psychotherapy as a treatment for dissociative identity disorder comorbid with major depressive disorder and alcohol dependence.

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Pollock, Brianna E; Macfie, Jenny; Elledge, L Christian

2017-01-01

We report on the treatment and successful outcome of a 58-year-old Native American male with a history of complex trauma presenting with dissociative identity disorder (DID) and major depressive disorder. The treatment included a trauma-informed phase-based psychotherapy as recommended by the International Society for the Study of Trauma and Dissociation for treating DID. We assessed symptoms at baseline and at three additional time points over the course of 14 months. We utilized the Reliable Change Index to examine statistically significant change in symptoms over the course of treatment. Significant symptom improvements were realized posttreatment across all measured domains of functioning, including dissociative symptoms, alcohol abuse, depression, anxiety, and emotion regulation skills. Moreover, the client no longer met criteria for DID, major depressive disorder, or alcohol abuse. Results are discussed in terms of the effectiveness of trauma-focused, phase-based treatment for DID for cases of complex trauma with comorbid disorders.

The identity impairment model: a longitudinal study of self-schemas as predictors of disordered eating behaviors.

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Stein, Karen Farchaus; Corte, Colleen

2008-01-01

There is broad consensus that the eating disorders of anorexia nervosa and bulimia nervosa stem from fundamental disturbances in identity development, but theoretically based empirical support is lacking. To extend work on the identity impairment model by investigating the relationship between organizational properties of the self-concept and change in disordered eating behaviors (DEB) in an at-risk sample of college women transitioning between freshman and sophomore years. The number, valence, and organization of self-schemas; availability of a fat body weight self-schema; and DEB were measured at baseline in the freshman year and 6 and 12 months later in a community-based sample of college women engaged in subthreshold DEB (n = 77; control: n = 41). Repeated-measures analyses of variances were used to examine group differences, and hierarchical regression analyses were used to predict disordered eating behaviors. Women in the DEB group had more negative self-schemas at baseline and showed information-processing evidence of a fat self-schema compared with the controls. The groups did not differ in the number of positive self-schemas or interrelatedness. The number of negative self-schemas predicted increases in the level of DEB at 6- and 12-month follow-up, and these effects were mediated through the fat self-schema. The number of positive self-schemas predicted the fat self-schema score but was not predictive of increases in DEB. Interrelatedness of the self-concept was not a significant predictor in this model. Impairments in overall collection of identities are predictive of the availability in memory of a fat self-schema, which in turn is predictive of increases in DEB during the transition to college in a sample of women at risk for an eating disorder. Therefore, organizational properties of the self-concept may be an important focus for effective primary and secondary prevention.

Nature versus nurture: identical twins and bariatric surgery.

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Hagedorn, Judith C; Morton, John M

2007-06-01

Genetics and environment both play a role in weight maintenance. Twin studies may help clarify the influence of nature vs nurture in weight loss. We present the largest U.S. experience with monozygotic (MZ) twins undergoing bariatric surgery. We retrospectively reviewed the charts of four sets of MZ twins who underwent Roux-en-Y gastric bypass (RYGBP) surgery and laparoscopic adjustable gastric band (LAGB) placement at three different institutions. BMI and co-morbidities were examined pre- and postoperatively, and laboratory values were recorded. All four sets of twins are female, live together, and have similar professions. Twin cohort 1 had near identical weight loss patterns after open RYGBP surgery in 1996 (preop 146/142 kg; 2 years 82/82; and 10 years 108/107). Twin cohort 1 also both underwent cholecystectomies within the first year postoperatively. Twin cohort 2 underwent laparoscopic RYGBP surgery and also required cholecystectomies in the first postoperative year. Cohort 2 also experienced nearly identical weight loss at 1 year (36.7% vs 37.0% BMI loss). Twin cohort 3 underwent LAGB placement with two different surgeons with differing amounts of weight loss at 6 months (6.5% vs 15.7% BMI loss). Finally, twin cohort 4 underwent laparoscopic RYGBP with 2-year BMI loss of 39% vs 34%. In twin cohort 4, the twin who lost less weight lived apart from her twin and extended family, and her weight loss was less than the twin living with her family. Two sets of MZ twins had identical responses to bariatric surgery. The other two sets of identical twins had differential weight loss results, possibly due to differences in surgical approach and social support. While genetics do exert a strong influence on weight loss and maintenance, this case series demonstrates the potential effect of social support and postoperative management upon postoperative weight loss in the presence of identical genetics.

Dissociative identity disorder among adolescents: prevalence in a university psychiatric outpatient unit.

Science.gov (United States)

Sar, Vedat; Onder, Canan; Kilincaslan, Ayse; Zoroglu, Süleyman S; Alyanak, Behiye

2014-01-01

The aim of this study was to determine the prevalence of dissociative identity disorder (DID) and other dissociative disorders among adolescent psychiatric outpatients. A total of 116 consecutive outpatients between 11 and 17 years of age who were admitted to the child and adolescent psychiatry clinic of a university hospital for the 1st time were evaluated using the Adolescent Dissociative Experiences Scale, adolescent version of the Child Symptom Inventory-4, Childhood Trauma Questionnaire, and McMaster Family Assessment Device. All patients were invited for an interview with the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) administered by 2 senior psychiatrists in a blind fashion. There was excellent interrater reliability between the 2 clinicians on SCID-D diagnoses and scores. Among 73 participants, 33 (45.2%) had a dissociative disorder: 12 (16.4%) had DID, and 21 (28.8%) had dissociative disorder not otherwise specified. There was no difference in gender distribution, childhood trauma, or family dysfunction scores between the dissociative and nondissociative groups. Childhood emotional abuse and family dysfunction correlated with self-reported dissociation. Of the dissociative adolescents, 93.9% had an additional psychiatric disorder. Among them, only separation anxiety disorder was significantly more prevalent than in controls. Although originally designed for adults, the SCID-D is promising for diagnosing dissociative disorders in adolescents, its modest congruence with self-rated dissociation and lack of relationship between diagnosis and childhood trauma and family dysfunction suggest that the prevalence rates obtained with this instrument originally designed for adults must be replicated. The introduction of diagnostic criteria for adolescent DID in revised versions of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, would refine the assessment of dissociative disorders in this age group.

Sex-sensitive cognitive performance in untreated patients with early onset gender identity disorder.

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Haraldsen, I R; Opjordsmoen, S; Egeland, T; Finset, A

2003-10-01

We explored whether the cognitive performance of gender identity disorder patients (GID) was comparable to that of their biological sex or skewed towards that of their gender identity. We tested four potentially sex-sensitive cognitive factors (rotation, visualization, perception, and verbalization) as well as two neutral factors (logic and arithmetic) in GID patients from Norway (GID-N, n = 33) or the USA (GID-US, n = 19) and in a control group (C, n = 29). The testing was undertaken prior to cross sex hormone treatment. Four-way ANOVA was applied in the final analysis of the cognitive performance and its dependency on different predictors (age, biological sex, education, group). In both GID groups as well as in the control group (C) males excelled in visualization and rotation, also when controlling for potential confounders (biological sex, group, age and education). No female advantage was detected. Furthermore, no interaction between biological sex and group assignment was revealed in the samples. In this study the cognitive pattern of GID patients is consistent with that of their biological sex and not that of their gender identity.

[Introducing treatment for dissociative identity disorder].

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Kitamura, Naoto

2011-01-01

This paper is a case presentation and study of the introduction of treatment for Dissociative Identity Disorder (DID). Since one manifestation of the pathology of DID is that sufferers avoid relying on others, at the start of treatment we try to stabilise the relationship between clinicians and patients; that is to say, we aim to build a treatment relationship which will be able to gradually overcome the patients' dread of relying on clinicians. In parallel with this we undertake a thorough psychiatric assessment of their condition. This is a standard treatment plan, which follows the general principles of clinical psychiatry. On the other hand, the specialist aspect of DID treatment calls for handling the unique behaviours of a group of mutually opposed alternating personalities appropriately, while always paying consistent attention to the traumatic memories which are connected to the formation and maintenance of the condition. This paper presents the first DID case which the author has taken charge of. There were some difficulties in the early stages of treatment, but after modifying some parts to acknowledge the alternating personalities as independent personalities in face-to-face interviews and psychological education for families, the stabilisation of the treatment structure progressed gradually and the stability of the relationship between clinicians and patients itself has become the focus.

Role of Sexuality in Body Integrity Identity Disorder (BIID) : A Cross-Sectional Internet-Based Survey Study

NARCIS (Netherlands)

Blom, Rianne M; van der Wal, Sija J; Vulink, Nienke C; Denys, D.

2017-01-01

BACKGROUND: Body integrity identity disorder (BIID)-a strong desire for amputation or paralysis-is often accompanied by feelings and cognitions of sexual arousal, although this sexual component has been largely neglected in the recent literature. AIM: To examine the presence of BIID-related sexual

Role of Sexuality in Body Integrity Identity Disorder (BIID): A Cross-Sectional Internet-Based Survey Study

NARCIS (Netherlands)

Blom, Rianne M.; van der Wal, Sija J.; Vulink, Nienke C.; Denys, Damiaan

2017-01-01

Body integrity identity disorder (BIID)-a strong desire for amputation or paralysis-is often accompanied by feelings and cognitions of sexual arousal, although this sexual component has been largely neglected in the recent literature. To examine the presence of BIID-related sexual arousal in

Sexual Orientation, Gender Identity, and Romantic Relationships in Adolescents and Adults with Autism Spectrum Disorder

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Dewinter, J.; De Graaf, H.; Begeer, S.

2017-01-01

This study compared sexual orientation and romantic relationship experience in a large sample of adolescents and adults with autism spectrum disorder (ASD) (n = 675) and general population peers (n = 8064). Gender identity was explored in the ASD group in relation to assigned gender at birth. Compared to general population peers, more people with…

Identity impairment and the eating disorders: content and organization of the self-concept in women with anorexia nervosa and bulimia nervosa.

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Stein, Karen Farchaus; Corte, Colleen

2007-01-01

The cognitive model of the self-concept was used to test the theoretical proposition that disturbances in overall identity development are a core vulnerability that lead to formation of a fat body weight self-definition and eating disorder symptomatology. Structural properties of the self-concept, availability in memory of a fat body weight self-schema, and eating disordered attitudes and behaviours were measured in women with anorexia nervosa (AN) (n = 26), bulimia nervosa (BN) (n = 53) and controls (n = 32). Women with (AN) and (BN) had fewer positive and more negative and highly interrelated self-schemas compared to controls, and women with BN showed information processing evidence of a fat self-schema available in memory. These self-concept properties predicted eating disordered attitudes and behaviour. Disturbances in the overall collection of identities--an impoverished self--is an important contributor to eating disorder symptomatology. The development of new positive selves may be an important factor in recovery. 2006 John Wiley & Sons, Ltd and Eating Disorders Association

Dissociative identity disorder and prepulse inhibition of the acoustic startle reflex

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Dale, Karl Yngvar; Flaten, Magne Arve; Elden, Åke; Holte, Arne

2008-01-01

A group of persons with dissociative identity disorder (DID) was compared with a group of persons with other dissociative disorders, and a group of nondiagnosed controls with regard to prepulse inhibition (PPI) of the acoustic startle reflex. The findings suggest maladaptive attentional processes at a controlled level, but not at a preattentive automatic level, in persons with DID. The prepulse occupied more controlled attentional resources in the DID group compared with the other two groups. Preattentive automatic processing, on the other hand, was normal in the DID group. Moreover, startle reflexes did not habituate in the DID group. In conclusion, increased PPI and delayed habituation is consistent with increased vigilance in individuals with DID. The present findings of reduced habituation of startle reflexes and increased PPI in persons with DID suggest the operation of a voluntary process that directs attention away from unpleasant or threatening stimuli. Aberrant voluntary attentional processes may thus be a defining characteristic in DID. PMID:18830396

First reported case of Lorazepam-assisted interview in a young Indian female presenting with dissociative identity disorder and improvement in symptoms after the interview.

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Mushtaq, Raheel; Shoib, Sheikh; Arif, Tasleem; Shah, Tabindah; Mushtaq, Sahil

2014-01-01

Dissociative identity disorder (DID) is one of the most fascinating disorders in psychiatry. The arduous search to reveal the obscurity of this disorder has led to colossal research in this area over the years. Although drug-assisted interviews are not widely used, they may be beneficial for some patients that do not respond to conventional treatments such as supportive psychotherapy or psychopharmacotherapy. Drug-assisted interviews facilitate recall of memories in promoting integration of dissociative information. We report a case of a 16-year-old female with dissociative identity disorder (DID) that was treated with lorazepam-assisted interview and there was rapid improvement in symptoms after the interview.

First Reported Case of Lorazepam-Assisted Interview in a Young Indian Female Presenting with Dissociative Identity Disorder and Improvement in Symptoms after the Interview

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Raheel Mushtaq

2014-01-01

Full Text Available Dissociative identity disorder (DID is one of the most fascinating disorders in psychiatry. The arduous search to reveal the obscurity of this disorder has led to colossal research in this area over the years. Although drug-assisted interviews are not widely used, they may be beneficial for some patients that do not respond to conventional treatments such as supportive psychotherapy or psychopharmacotherapy. Drug-assisted interviews facilitate recall of memories in promoting integration of dissociative information. We report a case of a 16-year-old female with dissociative identity disorder (DID that was treated with lorazepam-assisted interview and there was rapid improvement in symptoms after the interview.

Self-reported sleep disturbances in patients with dissociative identity disorder and post-traumatic stress disorder and how they relate to cognitive failures and fantasy proneness

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van Heugten-van der Kloet, Dalena; Huntjens, Rafaele; Giesbrecht, Timo; Merckelbach, Harald

2014-01-01

Sleep disturbances, fantasy proneness, cognitive failures, and dissociative symptoms are related to each other. However, the co-occurrence of these phenomena has been primarily studied in non-clinical samples. We investigated the correlations between these phenomena in dissociative identity disorder

Comparison of Masculine and Feminine Gender Roles in Iranian Patients with Gender Identity Disorder.

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Alavi, Kaveh; Eftekhar, Mehrdad; Jalali Nadoushan, Amir Hossein

2015-12-01

Gender identity disorders (GID) are heterogeneous disorders that may be influenced by culture and social norms. The aim of this study was to determine masculine and feminine gender roles in a group of Iranian patients with GID and compare these roles with two control groups. Twelve male-to-female (MF) and 27 female-to-male (FM) individuals with GID referred to Tehran Psychiatric Institute in Tehran, I. R. Iran were evaluated by self-report inventories and were compared with two groups of healthy controls (81 men and 89 women). Diagnoses were established based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. Data analysis was done using analysis of variance and chi-squared test. Masculine and feminine gender roles were assessed by two questionnaires: (i) Gender-Masculine (GM) and Gender-Feminine (GF) scales derived from the Minnesota Multiphasic Inventory-2 (MMPI-2); (ii) Bem Sex Role Inventory (BSRI). In the scales of masculinity, MF-GID individuals scored as male controls, but lower than female controls. FM-GID individuals scored similar to female controls and higher than male controls. In femininity scales, MF-GID individuals and control women seemed similar, and both scored higher than the other groups. FM-GID persons were considered less feminine than both controls in the GF scale of MMPI-2, but not in the BSRI. In both scales, FM-GID persons had higher scores than control women and MF-GID individuals. Iranian FM-GID individuals were less feminine than normal men. However, MF-GID individuals were similar to normal women or more feminine. Cultural considerations remain to be investigated. Alavi K, Eftekhar M and Jalali Nadoushan AH. Comparison of masculine and feminine gender roles in Iranian patients with gender identity disorder. Sex Med 2015;3:261-268.

The Desire for Amputation or Paralyzation : Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

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Blom, Rianne M; van Wingen, Guido A; van der Wal, Sija J; Luigjes, Judy; van Dijk, Milenna T; Scholte, H Steven; Denys, D.

2016-01-01

BACKGROUND: Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but

Type 3 Thyroplasty for a Patient with Female-to-Male Gender Identity Disorder

OpenAIRE

Yu Saito; Kazuhiro Nakamura; Shigeto Itani; Kiyoaki Tsukahara

2018-01-01

Objective. In most cases, about the voice of the patient with female-to-male/gender identity disorder (FTM/GID), hormone therapy makes the voice low-pitched. In success cases, there is no need for phonosurgery. However, hormone therapy is not effective in some cases. We perform type 3 thyroplasty in these cases. Method. Hormone therapy was started in 2008 but did not lower the speaking fundamental frequencies (SFFs). We therefore performed TP3 under local anesthesia. Results. In our case, the...

Sexual differentiation of the human brain: relation to gender identity, sexual orientation and neuropsychiatric disorders.

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Bao, Ai-Min; Swaab, Dick F

2011-04-01

During the intrauterine period a testosterone surge masculinizes the fetal brain, whereas the absence of such a surge results in a feminine brain. As sexual differentiation of the brain takes place at a much later stage in development than sexual differentiation of the genitals, these two processes can be influenced independently of each other. Sex differences in cognition, gender identity (an individual's perception of their own sexual identity), sexual orientation (heterosexuality, homosexuality or bisexuality), and the risks of developing neuropsychiatric disorders are programmed into our brain during early development. There is no evidence that one's postnatal social environment plays a crucial role in gender identity or sexual orientation. We discuss the relationships between structural and functional sex differences of various brain areas and the way they change along with any changes in the supply of sex hormones on the one hand and sex differences in behavior in health and disease on the other. Copyright © 2011 Elsevier Inc. All rights reserved.

Descriptive Study of Gender Dysphoria in Japanese Individuals with Male-to-Female Gender Identity Disorder.

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Shinohara, Yoshie; Nakatsuka, Mikiya

2018-04-01

We focus on Japanese individuals with gender identity disorder (GID), especially male-to-female (MTF) GID, who have experienced difficulty in adapting to social life. We clarify what gender dysphoria is, and we examine methods of intervention. Semi-structured interviews were conducted with 11 individuals with MTF-GID from August 2015 to April 2017. We categorized the subjects'experiences regarding dysphoria into the 'Onset of gender dysphoria,' 'Experience of feeling gender dysphoria,' and 'Changes due to receiving medical care.' The subjects reported experiencing great pain and distress because they did not fully understand that they were experiencing dysphoria and could not align their gender identity and their self-identity. All subjects described their experiences of dysphoria as negative. Additionally, all said that the dysphoria was alleviated by a medical intervention such as visiting a gender clinic, receiving a diagnosis and treatment, and changing their physical sex to the sex congruent with their gender identity. The provision of information at the gender clinic and the physical changes achieved by medical intervention exerted a positive effect both mentally and socially on the subjects, who suffered various physical, mental and social problems.

Dispelling myths about dissociative identity disorder treatment: an empirically based approach.

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Brand, Bethany L; Loewenstein, Richard J; Spiegel, David

2014-01-01

Some claim that treatment for dissociative identity disorder (DID) is harmful. Others maintain that the available data support the view that psychotherapy is helpful. We review the empirical support for both arguments. Current evidence supports the conclusion that phasic treatment consistent with expert consensus guidelines is associated with improvements in a wide range of DID patients' symptoms and functioning, decreased rates of hospitalization, and reduced costs of treatment. Research indicates that poor outcome is associated with treatment that does not specifically involve direct engagement with DID self-states to repair identity fragmentation and to decrease dissociative amnesia. The evidence demonstrates that carefully staged trauma-focused psychotherapy for DID results in improvement, whereas dissociative symptoms persist when not specifically targeted in treatment. The claims that DID treatment is harmful are based on anecdotal cases, opinion pieces, reports of damage that are not substantiated in the scientific literature, misrepresentations of the data, and misunderstandings about DID treatment and the phenomenology of DID. Given the severe symptomatology and disability associated with DID, iatrogenic harm is far more likely to come from depriving DID patients of treatment that is consistent with expert consensus, treatment guidelines, and current research.

The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

NARCIS (Netherlands)

Blom, Rianne M.; van Wingen, Guido A.; van der Wal, Sija J.; Luigjes, Judy; van Dijk, Milenna T.; Scholte, H. Steven; Denys, Damiaan

2016-01-01

Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but evidence for

Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma.

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Fisher, A D; Ristori, J; Fanni, E; Castellini, G; Forti, G; Maggi, M

2016-11-01

Disorders of Sex Development (DSD) are a wide range of congenital conditions characterized by an incongruence of components involved in sexual differentiation, including gender psychosexual development. The management of such disorders is complex, and one of the most crucial decision is represented by gender assignment. In fact, the primary goal in DSD is to have a gender assignment consistent with the underlying gender identity in order to prevent the distress related to a forthcoming Gender Dysphoria. Historically, gender assignment was based essentially on surgical outcomes, assuming the neutrality of gender identity at birth. This policy has been challenged in the past decade refocusing on the importance of prenatal and postnatal hormonal and genetic influences on psychosexual development. (1) to update the main psychological and medical issues that surround DSD, in particular regarding gender identity and gender assignment; (2) to report specific clinical recommendations according to the different diagnosis. A systematic search of published evidence was performed using Medline (from 1972 to March 2016). Review of the relevant literature and recommendations was based on authors' expertise. A review of gender identity and assignment in DSD is provided as well as clinical recommendations for the management of individuals with DSD. Given the complexity of this management, DSD individuals and their families need to be supported by a specialized multidisciplinary team, which has been universally recognized as the best practice for intersexual conditions. In case of juvenile GD in DSD, the prescription of gonadotropin-releasing hormone analogues, following the World Professional Association for Transgender Health and the Endocrine Society guidelines, should be considered. It should always be taken into account that every DSD person is unique and has to be treated with individualized care. In this perspective, international registries are crucial to improve the

Sexual Orientation, Gender Identity, and Romantic Relationships in Adolescents and Adults with Autism Spectrum Disorder.

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Dewinter, J; De Graaf, H; Begeer, S

2017-09-01

This study compared sexual orientation and romantic relationship experience in a large sample of adolescents and adults with autism spectrum disorder (ASD) (n = 675) and general population peers (n = 8064). Gender identity was explored in the ASD group in relation to assigned gender at birth. Compared to general population peers, more people with ASD, especially women, reported sexual attraction to both same- and opposite-sex partners. About half of the participants with ASD was in a relationship (heterosexual in most cases) and most of them lived with their partner. A notable number of autistic participants, again more women than men, reported gender non-conforming feelings. Attention to gender identity and sexual diversity in education and clinical work with people with ASD is advised.

Perspectives on Sexual Identity Formation, Identity Practices, and Identity Transitions Among Men Who Have Sex With Men in India.

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Tomori, Cecilia; Srikrishnan, Aylur K; Ridgeway, Kathleen; Solomon, Sunil S; Mehta, Shruti H; Solomon, Suniti; Celentano, David D

2018-01-01

Men who have sex with men (MSM) remain at high risk for HIV infection. Culturally specific sexual identities, encompassing sexual roles, behavior, and appearance, may shape MSM's experiences of stigmatization and discrimination, and affect their vulnerability to HIV. This multi-site qualitative study (n = 363) encompassing 31 focus group discussions (FGDs) and 121 in-depth interviews (IDIs) across 15 sites in India investigated sexual identity formation, identity practices, and transitions and their implications for HIV prevention. IDIs and FGDs were transcribed, translated, and underwent thematic analysis. Our findings document heterogeneous sexual identity formation, with MSM who have more gender nonconforming behaviors or appearance reporting greater family- and community-level disapproval, harassment, violence, and exclusion. Concealing feminine aspects of sexual identities was important in daily life, especially for married MSM. Some participants negotiated their identity practices in accordance with socioeconomic and cultural pressures, including taking on identity characteristics to suit consumer demand in sex work and on extended periods of joining communities of hijras (sometimes called TG or transgender women). Participants also reported that some MSM transition toward more feminine and hijra or transgender women identities, motivated by intersecting desires for feminine gender expression and by social exclusion and economic marginalization. Future studies should collect information on gender nonconformity stigma, and any changes in sexual identity practices or plans for transitions to other identities over time, in relation to HIV risk behaviors and outcomes.

Body integrity identity disorder crosses culture: case reports in the Japanese and Chinese literature.

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Blom, Rianne M; Vulink, Nienke C; van der Wal, Sija J; Nakamae, Takashi; Tan, Zhonglin; Derks, Eske M; Denys, Damiaan

2016-01-01

Body integrity identity disorder (BIID) is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only Western patients with BIID, suggesting that the disorder might be merely prevalent in the West. To scrutinize this assumption, and to extend our knowledge of the etiology of BIID, it is important to trace cases with BIID in non-Western populations. Our objective was to review Chinese and Japanese literature on BIID to learn about its presence in populations with a different genetic background. A systematic literature search was performed in databases containing Japanese and Chinese research, published in the respective languages. Five Japanese articles of BIID were identified which described two cases of BIID, whereas in the Chinese databases only BIID-related conditions were found. This article reports some preliminary evidence that BIID is also present in non-Western countries. However, making general statements about the biological background of the disorder is hampered by the extremely low number of cases found. This low number possibly resulted from the extreme secrecy associated with the disorder, perhaps even more so in Asian countries.

Separating Fact from Fiction: An Empirical Examination of Six Myths About Dissociative Identity Disorder.

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Brand, Bethany L; Sar, Vedat; Stavropoulos, Pam; Krüger, Christa; Korzekwa, Marilyn; Martínez-Taboas, Alfonso; Middleton, Warwick

2016-01-01

Dissociative identity disorder (DID) is a complex, posttraumatic, developmental disorder for which we now, after four decades of research, have an authoritative research base, but a number of misconceptualizations and myths about the disorder remain, compromising both patient care and research. This article examines the empirical literature pertaining to recurrently expressed beliefs regarding DID: (1) belief that DID is a fad, (2) belief that DID is primarily diagnosed in North America by DID experts who overdiagnose the disorder, (3) belief that DID is rare, (4) belief that DID is an iatrogenic, rather than trauma-based, disorder, (5) belief that DID is the same entity as borderline personality disorder, and (6) belief that DID treatment is harmful to patients. The absence of research to substantiate these beliefs, as well as the existence of a body of research that refutes them, confirms their mythical status. Clinicians who accept these myths as facts are unlikely to carefully assess for dissociation. Accurate diagnoses are critical for appropriate treatment planning. If DID is not targeted in treatment, it does not appear to resolve. The myths we have highlighted may also impede research about DID. The cost of ignorance about DID is high not only for individual patients but for the whole support system in which they reside. Empirically derived knowledge about DID has replaced outdated myths. Vigorous dissemination of the knowledge base about this complex disorder is warranted.

A right hemisphere safety backup at work: hypotheses for deep hypnosis, post-traumatic stress disorder, and dissociation identity disorder.

Science.gov (United States)

Burnand, Gordon

2013-09-01

Problem theory points to an a priori relation between six key problems of living, to which people have adapted through evolution. Children are guided through the problems one by one, learning to switch between them automatically and unawares. The first problem of raising hope of certainty (about the environment), is dealt with in the right hemisphere (RH). The second of raising hope of freedom (or power to control), is dealt with in the left hemisphere (LH). Here adventurousness and ignoring the goodness of outcomes potentially create recklessness. When uncertainty rises the RH activates a backup with an override that substitutes immobility, takes over sensory inputs, but allows obedience to parental commands, and a cut-out that stops new work on the freedom problem. Support for the use of the backup by infants is found in the immobility that precedes the crying in strange conditions, and in childhood EEGs. The hypothesis that the backup is active in deep hypnosis imposes accord on findings that appear contradictory. For example it accounts for why observations during deep hypnosis emphasize the activity of the RH, but observations of responsive people not under hypnosis emphasize the activity of the LH. The hypothesis that the backup is active in post-traumatic stress disorder (PTSD) is supported by (a) fMRI observations that could reflect the cut-out, in that part of the precuneus has low metabolism, (b) the recall of motionlessness at the time of the trauma, (c) an argument that playing dead as a defence against predators is illogical, (d) the ease of hypnosis. With dissociative identity disorder (DID), the theory is consistent with up to six alters that have executive control and one trauma identity state where childhood traumas are re-experienced. Support for the cut-out affecting the trauma identity state comes from suppression of part of the precuneus and other parts of the parietal lobe when the trauma identity state is salient and a general script about a

[Background and practical use of the assessment of identity development in adolescence (AIDA)].

Science.gov (United States)

Birkhölzer, Marc; Goth, Kirstin; Schrobildgen, Christian; Schmeck, Klaus; Schlüter-Müller, Susanne

2015-01-01

A paradigm shift towards early detection and intervention of personality disorders in adolescence to prevent persistent and chronic suffering is currently taking place. Aside further distinct areas of impaired psychosocial integrity, disturbed identity development is seen as one core component of personality disorders. Thus, the detection of early antecedents of impaired identity development is an important step to allow for early intervention. The self-report questionnaire Assessment of Identity Development in Adolescence (AIDA) is a reliable and valid diagnostic instrument to detect disturbed identity development. This questionnaire allows for global assessment of identity and a differentiation in fundamental subdomains as well and distinguishes between identity diffusion on one side and consolidated and stable identity on the other. In clinical practice, it supports the differentiation between severely disturbed identity as the core component of personality disorders and identity crisis or stable identity development that can be found in other mental disorders.

Finger length ratio (2D:4D) in adults with gender identity disorder.

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Kraemer, Bernd; Noll, Thomas; Delsignore, Aba; Milos, Gabriella; Schnyder, Ulrich; Hepp, Urs

2009-06-01

From early childhood, gender identity and the 2nd to 4th finger length ratio (2D:4D) are discriminative characteristics between sexes. Both the human brain and 2D:4D may be influenced by prenatal testosterone levels. This calls for an examination of 2D:4D in patients with gender identity disorder (GID) to study the possible influence of prenatal testosterone on gender identity. Until now, the only study carried out on this issue suggests lower prenatal testosterone levels in right-handed male-to-female GID patients (MtF). We compared 2D:4D of 56 GID patients (39 MtF; 17 female-to-male GID patients, FtM) with data from a control sample of 176 men and 190 women. Bivariate group comparisons showed that right hand 2D:4D in MtF was significantly higher (feminized) than in male controls, but similar to female controls. The comparison of 2D:4D ratios of biological women revealed significantly higher (feminized) values for right hands of right handed FtM. Analysis of variance confirmed significant effects for sex and for gender identity on 2D:4D ratios but not for sexual orientation or for the interaction among variables. Our results indirectly point to the possibility of a weak influence of reduced prenatal testosterone as an etiological factor in the multifactorially influenced development of MtF GID. The development of FtM GID seems even more unlikely to be notably influenced by prenatal testosterone.

The centrality of affective instability and identity in Borderline Personality Disorder: Evidence from network analysis

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Costantini, Giulio; De Panfilis, Chiara

2017-01-01

We argue that the series of traits characterizing Borderline Personality Disorder samples do not weigh equally. In this regard, we believe that network approaches employed recently in Personality and Psychopathology research to provide information about the differential relationships among symptoms would be useful to test our claim. To our knowledge, this approach has never been applied to personality disorders. We applied network analysis to the nine Borderline Personality Disorder traits to explore their relationships in two samples drawn from university students and clinical populations (N = 1317 and N = 96, respectively). We used the Fused Graphical Lasso, a technique that allows estimating networks from different populations separately while considering their similarities and differences. Moreover, we examined centrality indices to determine the relative importance of each symptom in each network. The general structure of the two networks was very similar in the two samples, although some differences were detected. Results indicate the centrality of mainly affective instability, identity, and effort to avoid abandonment aspects in Borderline Personality Disorder. Results are consistent with the new DSM Alternative Model for Personality Disorders. We discuss them in terms of implications for therapy. PMID:29040324

[Gender identity disorders or andromimetic behaviour in a victim of incest--a case study].

Science.gov (United States)

Piegza, Magdalena; Leksowska, Aleksandra; Pudlo, Robert; Badura-Brzoza, Karina; Matysiakiewicz, Jerzy; Gierlotka, Zbigniew; Gorczyca, Piotr W

2014-01-01

Nowadays, it is becoming increasingly difficult to clearly classify the issues associated with the phenomenon of gender dysphoria due to the fact that one identifies oneself in the context of increasingly fluid categories of gender identity-- an intrinsic sense of being a woman or a man. The authors present a woman whose internal problems connected with her sexuality and incomplete identification with the role attributed to her gender originate from her family history. Long-lasting, traumatic experiences of incestuous abuse and violence on the part of close relatives disturbed her development in many areas of personality and functioning. The aim of the study was to verify the hypothesis of the existence of gender identity disorder accompanied by depressive disorders. In addition to the medical history, the study of patient's problems included the following diagnostic tools: the Minnesota Multiphasic Personality Inventory (MMPI) and the Rorschach Inkblot Test in a CSR Exner system (TPA). The study revealed that as for sexual identification, the patient unambiguously identifies herself as a woman. Her behaviour to become like a man does not deny her sex, or even involve a temporary need of belonging to the opposite sex. It should be interpreted in the broader context of her traumatic experiences, not just sexual, but also concerning different aspects of a female gender role.

[Gender identity disorder: challenges and specificity in the treatment of requests for sexual reassignment].

Science.gov (United States)

Pécoud, P; Pralong, F; Bauquis, O; Stiefel, F

2011-02-16

Gender identity disorder is defined as a permanent desire to relieve one's own sexual features to acquire the sexual features and line to life of the opposite sex. The diagnosis is based on the psychiatric evaluation and treatment on an interdisciplinary approach by endocrinologists, surgeons and psychiatrists, and can be conceptualized into distinct phases: diagnostic evaluation, real life experience, hormonal treatment and surgery. Multiples challenges have to be faced, especially by the psychiatrist who follows the patient during the whole process.

Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study

OpenAIRE

Schlumpf, Yolanda R.; Reinders, Antje A. T. S.; Nijenhuis, Ellert R. S.; Luechinger, Roger; van Osch, Matthias J. P.; Jäncke, Lutz

2014-01-01

Background: In accordance with the Theory of Structural Dissociation of the Personality (TSDP), studies of dissociative identity disorder (DID) have documented that two prototypical dissociative subsystems of the personality, the "Emotional Part'' (EP) and the "Apparently Normal Part'' (ANP), have different biopsychosocial reactions to supraliminal and subliminal trauma-related cues and that these reactions cannot be mimicked by fantasy prone healthy controls nor by actors. Methods: Arterial ...

Systemic Case Formulation, Individualized Process Monitoring, and State Dynamics in a Case of Dissociative Identity Disorder.

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Schiepek, Günter K; Stöger-Schmidinger, Barbara; Aichhorn, Wolfgang; Schöller, Helmut; Aas, Benjamin

2016-01-01

Objective: The aim of this case report is to demonstrate the feasibility of a systemic procedure (synergetic process management) including modeling of the idiographic psychological system and continuous high-frequency monitoring of change dynamics in a case of dissociative identity disorder. The psychotherapy was realized in a day treatment center with a female client diagnosed with borderline personality disorder (BPD) and dissociative identity disorder. Methods: A three hour long co-creative session at the beginning of the treatment period allowed for modeling the systemic network of the client's dynamics of cognitions, emotions, and behavior. The components (variables) of this idiographic system model (ISM) were used to create items for an individualized process questionnaire for the client. The questionnaire was administered daily through an internet-based monitoring tool (Synergetic Navigation System, SNS), to capture the client's individual change process continuously throughout the therapy and after-care period. The resulting time series were reflected by therapist and client in therapeutic feedback sessions. Results: For the client it was important to see how the personality states dominating her daily life were represented by her idiographic system model and how the transitions between each state could be explained and understood by the activating and inhibiting relations between the cognitive-emotional components of that system. Continuous monitoring of her cognitions, emotions, and behavior via SNS allowed for identification of important triggers, dynamic patterns, and psychological mechanisms behind seemingly erratic state fluctuations. These insights enabled a change in management of the dynamics and an intensified trauma-focused therapy. Conclusion: By making use of the systemic case formulation technique and subsequent daily online monitoring, client and therapist continuously refer to detailed visualizations of the mental and behavioral network and

Systemic Case Formulation, Individualized Process Monitoring, and State Dynamics in a Case of Dissociative Identity Disorder.

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Guenter Karl Schiepek

2016-10-01

Full Text Available Objective. The aim of this case report is to demonstrate the feasibility of a systemic procedure (synergetic process management including modeling of the idiographic psychological system and continuous high-frequency monitoring of change dynamics in a case of dissociative identity disorder. The psychotherapy was realized in a day treatment center with a female client diagnosed with borderline personality disorder (BPD and dissociative identity disorder. Methods. A three hour long co-creative session at the beginning of the treatment period allowed for modeling the systemic network of the client’s dynamics of cognitions, emotions, and behavior. The components (variables of this idiographic system model (ISM were used to create items for an individualized process questionnaire for the client. The questionnaire was administered daily through an internet-based monitoring tool (Synergetic Navigation System, SNS, to capture the client’s individual change process continuously throughout the therapy and after-care period. The resulting time series were reflected by therapist and client in therapeutic feedback sessions. Results. For the client it was important to see how the personality states dominating her daily life were represented by her idiographic system model and how the transitions between each state could be explained and understood by the activating and inhibiting relations between the cognitive-emotional components of that system. Continuous monitoring of her cognitions, emotions, and behavior via SNS allowed for identification of important triggers, dynamic patterns, and psychological mechanisms behind seemingly erratic state fluctuations. These insights enabled a change in management of the dynamics and an intensified trauma-focused therapy. Conclusion. By making use of the systemic case formulation technique and subsequent daily online monitoring, client and therapist continuously refer to detailed visualizations of the mental and

From mental disorder to iatrogenic hypogonadism: dilemmas in conceptualizing gender identity variants as psychiatric conditions.

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Meyer-Bahlburg, Heino F L

2010-04-01

The categorization of gender identity variants (GIVs) as "mental disorders" in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association is highly controversial among professionals as well as among persons with GIV. After providing a brief history of GIV categorizations in the DSM, this paper presents some of the major issues of the ongoing debate: GIV as psychopathology versus natural variation; definition of "impairment" and "distress" for GID; associated psychopathology and its relation to stigma; the stigma impact of the mental-disorder label itself; the unusual character of "sex reassignment surgery" as a psychiatric treatment; and the consequences for health and mental-health services if the disorder label is removed. Finally, several categorization options are examined: Retaining the GID category, but possibly modifying its grouping with other syndromes; narrowing the definition to dysphoria and taking "disorder" out of the label; categorizing GID as a neurological or medical rather than a psychiatric disorder; removing GID from both the DSM and the International Classification of Diseases (ICD); and creating a special category for GIV in the DSM. I conclude that-as also evident in other DSM categories-the decision on the categorization of GIVs cannot be achieved on a purely scientific basis, and that a consensus for a pragmatic compromise needs to be arrived at that accommodates both scientific considerations and the service needs of persons with GIVs.

An experience of group work with parents of children and adolescents with gender identity disorder.

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Di Ceglie, Domenico; Thümmel, Elizabeth Coates

2006-07-01

This article gives an account of an experience of group work with parents and carers who had children or adolescents with gender identity disorder (GID). The history of this intervention within the context of a service for children with gender identity problems is outlined. The limited literature on the subject is reviewed. Group meetings were held monthly for 6 months, facilitated by two therapists (the authors). Selection criteria for group participants, the aims of the group and the methodology for achieving those aims are described. Some information about the group's composition is provided. The structure and content of the group sessions are outlined together with details of some group interactions. Finally, we present the results of an evaluation of the intervention through feedback questionnaires and discuss the value for the children and young people of running such groups.

Descriptive Study of Gender Dysphoria in Japanese Individuals with Male-to-Female Gender Identity Disorder

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Shinohara, Yoshie; Nakatsuka, Mikiya

2018-01-01

We focus on Japanese individuals with gender identity disorder (GID), especially male-to-female (MTF) GID, who have experienced difficulty in adapting to social life. We clarify what gender dysphoria is, and we examine methods of intervention. Semi-structured interviews were conducted with 11 individuals with MTF-GID from August 2015 to April 2017. We categorized the subjects’experiences regarding dysphoria into the ‘Onset of gender dysphoria,’ ‘Experience of feeling gender dysphoria,’ and ‘C...

Sexual orientation, gender identity, and romantic relationships in adolescents and adults with Autism Spectrum Disorder

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Dewinter, J.; De Graaf, H.; Begeer, S.

2017-01-01

This study compared sexual orientation and romantic relationship experience in a large sample of adolescents and adults with autism spectrum disorder (ASD) (n?=?675) and general population peers (n?=?8064). Gender identity was explored in the ASD group in relation to assigned gender at birth. Compared to general population peers, more people with ASD, especially women, reported sexual attraction to both same- and opposite-sex partners. About half of the participants with ASD was in a relation...

Identity-related autobiographical memories and cultural life scripts in patients with Borderline Personality Disorder.

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Jørgensen, Carsten René; Berntsen, Dorthe; Bech, Morten; Kjølbye, Morten; Bennedsen, Birgit E; Ramsgaard, Stine B

2012-06-01

Disturbed identity is one of the defining characteristics of Borderline Personality Disorder manifested in a broad spectrum of dysfunctions related to the self, including disturbances in meaning-generating self-narratives. Autobiographical memories are memories of personal events that provide crucial building-blocks in our construction of a life-story, self-concept, and a meaning-generating narrative identity. The cultural life script represents culturally shared expectations as to the order and timing of life events in a prototypical life course within a given culture. It is used to organize one's autobiographical memories. Here, 17 BPD-patients, 14 OCD-patients, and 23 non-clinical controls generated three important autobiographical memories and their conceptions of the cultural life script. BPD-patients reported substantially more negative memories, fewer of their memories were of prototypical life script events, their memory narratives were less coherent and more disoriented, and the overall typicality of their life scripts was lower as compared with the other two groups. Copyright © 2012 Elsevier Inc. All rights reserved.

Abnormal Hippocampal Morphology in Dissociative Identity Disorder and Posttraumatic Stress Disorder Correlates with Childhood Trauma and Dissociative Symptoms

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Chalavi, Sima; Vissia, Eline M.; Giesen, Mechteld E.; Nijenhuis, Ellert R.S.; Draijer, Nel; Cole, James H.; Dazzan, Paola; Pariante, Carmine M.; Madsen, Sarah K.; Rajagopalan, Priya; Thompson, Paul M.; Toga, Arthur W.; Veltman, Dick J.; Reinders, Antje A.T.S.

2015-01-01

Smaller hippocampal volume has been reported in individuals with posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID), but the regional specificity of hippocampal volume reductions and the association with severity of dissociative symptoms and/or childhood traumatization are still unclear. Brain structural MRI scans were analyzed for 33 outpatients (17 with DID and 16 with PTSD only) and 28 healthy controls (HC), all matched for age, sex, and education. DID patients met criteria for PTSD (PTSD-DID). Hippocampal global and subfield volumes and shape measurements were extracted. We found that global hippocampal volume was significantly smaller in all 33 patients (left: 6.75%; right: 8.33%) compared to HC. PTSD-DID (left: 10.19%; right: 11.37%) and PTSD-only with a history of childhood traumatization (left: 7.11%; right: 7.31%) had significantly smaller global hippocampal volume relative to HC. PTSD-DID had abnormal shape and significantly smaller volume in the CA2-3, CA4-DG and (pre)subiculum compared to HC. In the patient groups, smaller global and subfield hippocampal volumes significantly correlated with higher severity of childhood traumatization and dissociative symptoms. These findings support a childhood trauma-related etiology for abnormal hippocampal morphology in both PTSD and DID and can further the understanding of neurobiological mechanisms involved in these disorders. PMID:25545784

Elena: A case of dissociative identity disorder from the 1920s.

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Schimmenti, Adriano

2017-01-01

In 1930, Italian psychiatrist Giovanni Enrico Morselli described the history, diagnosis, and treatment of his patient Elena. The case of Elena has been considered in literature as one of the most remarkable cases of multiple personality ever published. In fact, before treatment, Elena showed alternating French- and Italian-speaking personalities, with the Italian personality knowing nothing of her French counterparts. After a difficult treatment involving recovered memories of incestuous attacks by her father, which were proven to be true, Elena fully recovered from her symptoms. In this article, the author presents details of the case that were not available in the international literature before. He also discusses Elena's psychological and somatoform symptoms according to a contemporary perspective on the relationally traumatic origins of dissociation and dissociative identity disorder.

Perception, experience and body identity.

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López-Ibor, Juan J; Ortiz, Tomás; López-Ibor, María I

2011-12-01

Physician has to know the patient in the disease and not only the disease in the patient, from the dual perspective of the body as object and the body as subject. This also affects the patient who has to cope with the reality of having a body that bursts into the subject's consciousness as a vital threat, as source of discomfort and inability and being a body (Marcel). The human body in its dual aspect has been and is a great unknown, if not a great outrage in spite of the fact that we are our body and our body is each of us. We sometimes do not feel as we are and thus a confrontation arises, sometimes more normal, others more morbid. This forces the physician to face complex ethics considerations and the scientist to accept a personal identity disorder. Dualism considers that there are two substances in us, one that distinguishes us from other beings and from the rest of the individuals of the human species, the soul, the psychic life, mind or consciousness, and another more insubstancial one, the body. The aim of the first substance is to dominate the body, to survive it after death when it is, already a corpse is meant to become putrefied, is buried, incinerated or thrown to the depth of the sea. This dualism aims to explain the origin of the evil and the attitude to defeat it and it does so efficiently. This anthropology has very ancient roots (the Upvanishads, in the orphic texts, in Plato), it is the core of Gnostic thought and the foundation of the modern science since Descartes. Some monist perspectives are a masked dualism or a mereologic fallacy, according to which, the brain is conscious, when that what is conscious is the subject, although the subject, with the brain could not be conscious. Therefore, a new perspective is proposed, chiasmatic or janicular monism, that considers the adaptive value of focusing on the reality from two perspectives, as physical universe and the world of interpersonal relationships. In the agnosias and in the phantom limb

Social Identity in People with Multiple Sclerosis: An Examination of Family Identity and Mood.

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Barker, Alex B; Lincoln, Nadina B; Hunt, Nigel; dasNair, Roshan

2018-01-01

Mood disorders are highly prevalent in people with multiple sclerosis (MS). MS causes changes to a person's sense of self. The Social Identity Model of Identity Change posits that group membership can have a positive effect on mood during identity change. The family is a social group implicated in adjustment to MS. The objectives of this study were to investigate whether family identity can predict mood in people with MS and to test whether this prediction was mediated by social support and connectedness to others. This cross-sectional survey of 195 participants comprised measures of family identity, family social support, connectedness to others, and mood. Family identity predicted mood both directly and indirectly through parallel mediators of family social support and connectedness to others. Family identity predicted mood as posited by the Social Identity Model of Identity Change. Involving the family in adjustment to MS could reduce low mood.

Dissociative identity disorder and the process of couple therapy.

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Macintosh, Heather B

2013-01-01

Couple therapy in the context of dissociative identity disorder (DID) has been neglected as an area of exploration and development in the couple therapy and trauma literature. What little discussion exists focuses primarily on couple therapy as an adjunct to individual therapy rather than as a primary treatment for couple distress and trauma. Couple therapy researchers have begun to develop adaptations to provide effective support to couples dealing with the impact of childhood trauma in their relationships, but little attention has been paid to the specific and complex needs of DID patients in couple therapy (H. B. MacIntosh & S. Johnson, 2008 ). This review and case presentation explores the case of "Lisa," a woman diagnosed with DID, and "Don," her partner, and illustrates the themes of learning to communicate, handling conflicting needs, responding to child alters, and addressing sexuality and education through their therapy process. It is the hope of the author that this discussion will renew interest in the field of couple therapy in the context of DID, with the eventual goal of developing an empirically testable model of treatment for couples.

The scientific status of childhood dissociative identity disorder: a review of published research.

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Boysen, Guy A

2011-01-01

Dissociative identity disorder (DID) remains a controversial diagnosis due to conflicting views on its etiology. Some attribute DID to childhood trauma and others attribute it to iatrogenesis. The purpose of this article is to review the published cases of childhood DID in order to evaluate its scientific status, and to answer research questions related to the etiological models. I searched MEDLINE and PsycINFO records for studies published since 1980 on DID/multiple personality disorder in children. For each study I coded information regarding the origin of samples and diagnostic methods. The review produced a total of 255 cases of childhood DID reported as individual case studies (44) or aggregated into empirical studies (211). Nearly all cases (93%) emerged from samples of children in treatment, and multiple personalities was the presenting problem in 23% of the case studies. Four US research groups accounted for 65% of all 255 cases. Diagnostic methods typically included clinical evaluation based on Diagnostic and Statistical Manual of Mental Disorder criteria, but hypnosis, structured interviews, and multiple raters were rarely used in diagnoses. Despite continuing research on the related concepts of trauma and dissociation, childhood DID itself appears to be an extremely rare phenomenon that few researchers have studied in depth. Nearly all of the research that does exist on childhood DID is from the 1980s and 1990s and does not resolve the ongoing controversies surrounding the disorder. Copyright © 2011 S. Karger AG, Basel.

Dissociative identity disorder and prepulse inhibition of the acoustic startle reflex

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Karl Yngvar Dale

2008-06-01

Full Text Available Karl Yngvar Dale1, Magne Arve Flaten1, Åke Elden1, Arne Holte21Department of Psychology, University of Tromsø, Norway; 2The Norwegian Institute of Public Health, Department of Mental Health, Oslo, Norway and University of Oslo, NorwayAbstract: A group of persons with dissociative identity disorder (DID was compared with a group of persons with other dissociative disorders, and a group of nondiagnosed controls with regard to prepulse inhibition (PPI of the acoustic startle reflex. The findings suggest maladaptive attentional processes at a controlled level, but not at a preattentive automatic level, in persons with DID. The prepulse occupied more controlled attentional resources in the DID group compared with the other two groups. Preattentive automatic processing, on the other hand, was normal in the DID group. Moreover, startle reflexes did not habituate in the DID group. In conclusion, increased PPI and delayed habituation is consistent with increased vigilance in individuals with DID. The present findings of reduced habituation of startle reflexes and increased PPI in persons with DID suggest the operation of a voluntary process that directs attention away from unpleasant or threatening stimuli. Aberrant voluntary attentional processes may thus be a defining characteristic in DID.Keywords: dissociation, DID, PPI, startle, habituation

Paralyzed by desire: a new type of body integrity identity disorder.

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Giummarra, Melita J; Bradshaw, John L; Hilti, Leonie M; Nicholls, Michael E R; Brugger, Peter

2012-03-01

Body incongruity in body integrity identity disorder (BIID) manifests in the desire to have a healthy limb amputated. We describe a variant of the disorder: the desire to become paralyzed (paralysis-BIID). Sixteen otherwise healthy participants, recruited through Internet-based forums, websites, or word of mouth, completed questionnaires about details of their desire and accompanying symptoms. Onset of the desire for paralysis typically preceded puberty. All participants indicated a specific level for desired spinal cord injury. All participants simulated paralysis through mental imagery or physical pretending, and 9 (56%) reported erotic interest in paraplegia and/or disability. Our key new finding was that 37.5% of paralysis-BIID participants were women, compared with 4.4% women in a sample of 68 individuals with amputation-BIID. BIID reflects a disunity between self and body, usually with a prominent sexual component. Sex-related differences are emerging: unlike men, a higher proportion of women desire paralysis than desire amputation, and, while men typically seek unilateral amputation, women typically seek bilateral amputation. We propose that these sex-related differences in BIID manifestation may relate to sex differences in cerebral lateralization, or to disruption of representation and/or processing of body-related information in right-hemisphere frontoparietal networks.

Body integrity identity disorder (BIID)--is the amputation of healthy limbs ethically justified?

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Müller, Sabine

2009-01-01

The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation in analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image.

Dissociative identity disorder (DID) in clinical practice - what you don't see may hurt you.

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Leonard, David; Tiller, John

2016-02-01

To identify problems that interfere with the recognition, diagnosis and management of people with dissociative identity disorder (DID) presenting to psychiatric outpatient and inpatient services and suggest solutions. Problems and suggested solutions associated with clinical presentations and management of people with DID are outlined with references to relevant literature. Problems in the recognition and management of DID are described. These lead to delays in diagnosis and costly, inappropriate management, destructive to services, staff and patients alike. Problems include lack of understanding and experience and scepticism about the disorder, resulting in failure to provide appropriate treatment.Some suggestions to improve recognition and management are included. Better recognition, diagnosis and management of DID will lead to better and more cost effective outcomes. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Identity degradation and mental disorder: an empirical assessment of the Conduct Impairment Scale.

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Schley, W R; Wagenfeld, M O

1979-02-01

Proponents of the medical models have held that mental disorder is best measured in terms of some inventory of symptoms indicative of an underlying disease. Alternatively, critics have argued that mental disorder is the result of a degraded ascribed role, a discrepancy between the person and his environment, or the degradation of identity. The issue goes beyond academic debate, with important implications for case-finding and program development in community mental health. Theodore Sarbin has developed a 58-item "Conduct Impairment Scale" to operationalize the concept of "Identity Degradation" and proposed it as a substitute for the medical model. Three dimensions are posited: status, value, and involvement. An appropriate level of reliability and clustering of scale items are reported by Sarbin. In order to subject the scale to a more rigorous test, it was administered to a random sample of 208 respondents in four neighborhoods in Grand Rapids, Michigan, as part of a larger epidemiological study. In an effort to assess the validity of the scale, factor analytic methods were employed. A principal components model with varimax rotation was performed. It was found that items purporting to tap the three theoretical dimensions explicated by Sarbin did not load in the expected pattern. Additionally, the first three extracted factors accounted for only a small proportion of the total variance. Efforts to assess the reliability of the scale were more fruitful. A corrected split-half of .82 and coefficient alpha of .86 were obtained. It was concluded that the validity of the scale was not adequately demonstrated, and its use as an alternative to the medical model open to serious reservation.

Who Done It, Actually? Dissociative Identity Disorder for the Criminologist

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Adah Sachs

2015-07-01

Full Text Available Dissociative Identity Disorder (DID (American Psychiatric Association 2013 is examined in this paper from the perspective of its relevance to the criminologist. As this psychiatric condition is linked to severe and prolonged childhood abuse, accounts of DID patients inevitably involve reports of serious crimes, in which the person was the victim, perpetrator or witness. These reports can thus contain crucial information for criminal investigations by the police or for court proceedings. However, due to the person’s dissociation, such reports are often very confusing, hard to follow, hard to believe and difficult to obtain. They also frequently state that the person had ‘no choice’, a thorny notion for the criminologist (as well as for the clinician. Through the analysis of clinical examples, the paper explores how decisions are made by a person with DID, the notions of choice and ‘competent reasoning’, and the practical and ethical ways for interviewing a person with DID.

Dissociative part-dependent biopsychosocial reactions to backward masked angry and neutral faces : An fMRI study of dissociative identity disorder

NARCIS (Netherlands)

Schlumpf, Yolanda R.; Nijenhuis, Ellert R. S.; Chalavi, Sima; Weder, Ekaterina V.; Zimmermann, Eva; Luechinger, Roger; La Marca, Roberto; Reinders, A. A. T. Simone; Jaencke, Lutz

2013-01-01

Objective: The Theory of Structural Dissociation of the Personality (TSDP) proposes that dissociative identity disorder (DID) patients are fixed in traumatic memories as "Emotional Parts" (EP), but mentally avoid these as "Apparently Normal Parts" of the personality (ANP). We tested the hypotheses

Measuring fragmentation in dissociative identity disorder: the integration measure and relationship to switching and time in therapy.

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Barlow, M Rose; Chu, James A

2014-01-01

Some people with dissociative identity disorder (DID) have very little communication or awareness among the parts of their identity, while others experience a great deal of cooperation among alternate identities. Previous research on this topic has been sparse. Currently, there is no empirical measure of integration versus fragmentation in a person with DID. In this study, we report the development of such a measure. The goal of this study was to pilot the integration measure (IM) and to address its psychometric properties and relationships to other measures. The IM is the first standardized measure of integration in DID. Eleven women with DID participated in an experiment that included a variety of tasks. They filled out questionnaires about trauma and dissociation as well as the IM. They also provided verbal results about switching among alternate identities during the study sessions. Participants switched among identities an average of 5.8 times during the first session, and switching was highly correlated with trauma. Integration was related to switching, though this relationship may be non-linear. Integration was not related to time in psychotherapy. The IM provides a useful beginning to quantify and study integration and fragmentation in DID. Directions for future research are also discussed, including expanding the IM from this pilot. The IM may be useful in treatment settings to assess progress or change over time.

'Hooligans' abroad? Inter-group dynamics, social identity and participation in collective 'disorder' at the 1998 World Cup Finals.

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Stott, C; Hutchison, P; Drury, J

2001-09-01

During the 1998 Football World Cup Finals in France, English supporters were, once again, involved in major incidents of collective 'disorder'. Explanations for these incidents concentrated on the conflictual norms held by 'hooligans'. In contrast, Scottish supporters attending the tournament displayed norms of non-violence, explained by the popular press in terms of the absence of 'hooligans'. This study challenges this tendency to explain the presence or absence of 'disorder' in the context of football solely in terms of the presence or absence of 'hooligan' fans. Using data obtained from an ethnographic study of both Scottish and English supporters attending the tournament (N = 121), we examine the processes through which ordinarily 'peaceful' supporters would or would not become involved in collective conflict. In line with the Elaborated Social Identity Model (ESIM) of crowd behaviour, the analysis highlights the role of the intergroup context. Where out-group activity was understood as illegitimate in in-group terms, in-group members redefined their identity such that violent action toward out-group members came to be understood as legitimate. By contrast, where there was no out-group hostility, in-group members defined themselves through an explicit contrast with the 'hooligan' supporters of rival teams. This analysis represents an advance on previous studies of crowd behaviour by demonstrating how the ESIM can account for not only the presence, but also the absence, of collective 'disorder'.

Role of Sexuality in Body Integrity Identity Disorder (BIID): A Cross-Sectional Internet-Based Survey Study.

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Blom, Rianne M; van der Wal, Sija J; Vulink, Nienke C; Denys, Damiaan

2017-08-01

Body integrity identity disorder (BIID)-a strong desire for amputation or paralysis-is often accompanied by feelings and cognitions of sexual arousal, although this sexual component has been largely neglected in the recent literature. To examine the presence of BIID-related sexual arousal in subjects with BIID and explore clinical and demographic variables of subjects with BIID who do and do not possess this sexual arousal. Eighty individuals with BIID responded to an internet-based survey we created. For all subjects, restoring identity was the primary motivation for preferred body modification. We collected data about respondents' demographic, clinical, and sexual characteristics. Based on responses to questions about BIID-specific sexual desires, subjects were assigned to the group with BIID-related sexual feelings (S-BIID; n = 57) or the group without such feelings (NS-BIID; n = 23). Differences in clinical, demographic, and sexual characteristics between S-BIID and NS-BIID groups. Of the respondents, 71.3% endorsed S-BIID. Subjects with S-BIID were significantly more often men, religious, and of a homosexual identity compared with the NS-BIID group. Subjects with S-BIID also significantly more often reported a change in localization and/or intensity of their BIID feelings over time. Furthermore, 66.7% of subjects with S-BIID reported S-BIID as an additional motivation for body modification. Seven of the 57 subjects with S-BIID achieved their preferred body modification through (self)-amputation, whereas none of the subjects with NS-BIID did. BIID is a heterogeneous disorder in which subjects who self-reported comorbid sexual arousal more often resorted to (self-induced) amputation. This study contains the largest BIID cohort presented in the literature and is the first to genuinely research sexuality in BIID. The first limitation is the lack of face-to-face interviews with the subjects, so no clinical diagnoses could be made. Moreover, there is an

Changes in neurotic personality profile associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

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Rodziński, Paweł; Rutkowski, Krzysztof; Sobański, Jerzy A; Mielimąka, Michał; Murzyn, Agnieszka; Cyranka, Katarzyna; Dembińska, Edyta; Grządziel, Karolina; Klasa, Katarzyna; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna

2015-01-01

Analysis of associations between changes in neurotic personality profile and reductionof suicidal ideation (SI) - or lack of such reduction - defined as its elimination or reduction of its intensity in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men treated due to neurotic, behavioral or personality disorders in a day hospital between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. Patients who improved in terms of SI obtained significantly greater reduction of global neurotic personality disintegration (neuroticism) than others (ppsychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism) and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.

Does phasic trauma treatment make patients with dissociative identity disorder treatment more dissociative?

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Brand, Bethany; Loewenstein, Richard J

2014-01-01

Proponents of the iatrogenic model of the etiology of dissociative identity disorder (DID) have expressed concern that treatment focused on direct engagement and interaction with dissociated self-states harms DID patients. However, empirical data have shown that this type of DID treatment is beneficial. Analyzing data from the prospective Treatment of Patients With Dissociative Disorders (TOP DD) Study, we test empirically whether DID treatment is associated with clinically adverse manifestations of dissociated self-states: acting so differently that one feels like different people, hearing voices, and dissociative amnesia. We show that, over the course of the study, there were significant decreases in feeling like different people and hearing voices. These results indicate that this form of DID treatment does not lead to symptomatic worsening in these dimensions, as predicted by the iatrogenic model. Indeed, treatment provided by TOP DD therapists reduced, rather than increased, the extent to which patients experienced manifestations of pathological dissociation. Because severe symptomatology and impairment are associated with DID, iatrogenic harm may come from depriving DID patients of treatment that targets DID symptomatology.

Abnormal hippocampal morphology in dissociative identity disorder and post-traumatic stress disorder correlates with childhood trauma and dissociative symptoms.

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Chalavi, Sima; Vissia, Eline M; Giesen, Mechteld E; Nijenhuis, Ellert R S; Draijer, Nel; Cole, James H; Dazzan, Paola; Pariante, Carmine M; Madsen, Sarah K; Rajagopalan, Priya; Thompson, Paul M; Toga, Arthur W; Veltman, Dick J; Reinders, Antje A T S

2015-05-01

Smaller hippocampal volume has been reported in individuals with post-traumatic stress disorder (PTSD) and dissociative identity disorder (DID), but the regional specificity of hippocampal volume reductions and the association with severity of dissociative symptoms and/or childhood traumatization are still unclear. Brain structural magnetic resonance imaging scans were analyzed for 33 outpatients (17 with DID and 16 with PTSD only) and 28 healthy controls (HC), all matched for age, sex, and education. DID patients met criteria for PTSD (PTSD-DID). Hippocampal global and subfield volumes and shape measurements were extracted. We found that global hippocampal volume was significantly smaller in all 33 patients (left: 6.75%; right: 8.33%) compared with HC. PTSD-DID (left: 10.19%; right: 11.37%) and PTSD-only with a history of childhood traumatization (left: 7.11%; right: 7.31%) had significantly smaller global hippocampal volume relative to HC. PTSD-DID had abnormal shape and significantly smaller volume in the CA2-3, CA4-DG and (pre)subiculum compared with HC. In the patient groups, smaller global and subfield hippocampal volumes significantly correlated with higher severity of childhood traumatization and dissociative symptoms. These findings support a childhood trauma-related etiology for abnormal hippocampal morphology in both PTSD and DID and can further the understanding of neurobiological mechanisms involved in these disorders. © 2014 Wiley Periodicals, Inc.

Gender identity disorders in childhood and adolescence: currently debated concepts and treatment strategies.

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Korte, Alexander; Lehmkuhl, Ulrike; Goecker, David; Beier, Klaus Michael; Krude, Heiko; Grüters-Kieslich, Annette

2008-11-01

Gender identity disorders (GID) can appear even in early infancy with a variable degree of severity. Their prevalence in childhood and adolescence is below 1%. GID are often associated with emotional and behavioral problems as well as a high rate of psychiatric comorbidity. Their clinical course is highly variable. There is controversy at present over theoretical explanations of the causes of GID and over treatment approaches, particularly with respect to early hormonal intervention strategies. This review is based on a selective Medline literature search, existing national and international guidelines, and the results of a discussion among experts from multiple relevant disciplines. As there have been no large studies to date on the course of GID, and, in particular, no studies focusing on causal factors for GID, the evidence level for the various etiological models that have been proposed is generally low. Most models of these disorders assume that they result from a complex biopsychosocial interaction. Only 2.5% to 20% of all cases of GID in childhood and adolescence are the initial manifestation of irreversible transsexualism. The current state of research on this subject does not allow any valid diagnostic parameters to be identified with which one could reliably predict whether the manifestations of GID will persist, i.e., whether transsexualism will develop with certainty or, at least, a high degree of probability. The types of modulating influences that are known from the fields of developmental psychology and family dynamics have therapeutic implications for GID. As children with GID only rarely go on to have permanent transsexualism, irreversible physical interventions are clearly not indicated until after the individual's psychosexual development ist complete. The identity-creating experiences of this phase of development should not be restricted by the use of LHRH analogues that prevent puberty.

Identity, Bipolar Disorder, and the Problem of Self-Narration in Kay Redfield Jamison's An Unquiet Mind and Ellen Forney's Marbles.

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Mannon, Bethany Ober

2018-03-06

The field of narrative medicine holds that personal narratives about illness have the potential to give illness meaning and to create order out of disparate facets of experience, thereby aiding a patient's treatment and resisting universalizing medical discourse. Two narratives of bipolar disorder, Kay Redfield Jamison's prose memoir An Unquiet Mind (1995) and Ellen Forney's graphic memoir Marbles (2012) challenge these ideas. These writers demonstrate that one result of bipolar disorder is a rupture to their sense of identity, making straightforward and verbal forms of narrative impossible. During periods of relative mood stability, reliable memories of mania or depression are equally impossible. As a result, these memoirists seek to develop sources of self-knowledge other than memory and introspection, long the foundations of personal narrative. Finally, An Unquiet Mind and Marbles return attention to questions of selfhood at a time when scholarship on memoir rejects interpretations of life stories as clear and reliable expressions of identity.

Measuring fragmentation in dissociative identity disorder: the integration measure and relationship to switching and time in therapy

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Margaret Rose Barlow

2014-01-01

Full Text Available Background: Some people with dissociative identity disorder (DID have very little communication or awareness among the parts of their identity, while others experience a great deal of cooperation among alternate identities. Previous research on this topic has been sparse. Currently, there is no empirical measure of integration versus fragmentation in a person with DID. In this study, we report the development of such a measure. Objective: The goal of this study was to pilot the integration measure (IM and to address its psychometric properties and relationships to other measures. The IM is the first standardized measure of integration in DID. Method: Eleven women with DID participated in an experiment that included a variety of tasks. They filled out questionnaires about trauma and dissociation as well as the IM. They also provided verbal results about switching among alternate identities during the study sessions. Results: Participants switched among identities an average of 5.8 times during the first session, and switching was highly correlated with trauma. Integration was related to switching, though this relationship may be non-linear. Integration was not related to time in psychotherapy. Conclusions: The IM provides a useful beginning to quantify and study integration and fragmentation in DID. Directions for future research are also discussed, including expanding the IM from this pilot. The IM may be useful in treatment settings to assess progress or change over time.

Assessment of identity development and identity diffusion in adolescence - Theoretical basis and psychometric properties of the self-report questionnaire AIDA.

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Goth, Kirstin; Foelsch, Pamela; Schlüter-Müller, Susanne; Birkhölzer, Marc; Jung, Emanuel; Pick, Oliver; Schmeck, Klaus

2012-07-19

In the continuing revision of Diagnostic and Statistical Manual (DSM-V) "identity" is integrated as a central diagnostic criterion for personality disorders (self-related personality functioning). According to Kernberg, identity diffusion is one of the core elements of borderline personality organization. As there is no elaborated self-rating inventory to assess identity development in healthy and disturbed adolescents, we developed the AIDA (Assessment of Identity Development in Adolescence) questionnaire to assess this complex dimension, varying from "Identity Integration" to "Identity Diffusion", in a broad and substructured way and evaluated its psychometric properties in a mixed school and clinical sample. Test construction was deductive, referring to psychodynamic as well as social-cognitive theories, and led to a special item pool, with consideration for clarity and ease of comprehension. Participants were 305 students aged 12-18 attending a public school and 52 adolescent psychiatric inpatients and outpatients with diagnoses of personality disorders (N = 20) or other mental disorders (N = 32). Convergent validity was evaluated by covariations with personality development (JTCI 12-18 R scales), criterion validity by differences in identity development (AIDA scales) between patients and controls. AIDA showed excellent total score (Diffusion: α = .94), scale (Discontinuity: α = .86; Incoherence: α = .92) and subscale (α = .73-.86) reliabilities. High levels of Discontinuity and Incoherence were associated with low levels in Self Directedness, an indicator of maladaptive personality functioning. Both AIDA scales were significantly different between PD-patients and controls with remarkable effect sizes (d) of 2.17 and 1.94 standard deviations. AIDA is a reliable and valid instrument to assess normal and disturbed identity in adolescents. Studies for further validation and for obtaining population norms are in progress and may provide

Reducing the cost of dissociative identity disorder: Measuring the effectiveness of specialized treatment by frequency of contacts with mental health services.

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Lloyd, Mike

2016-01-01

It is important to understand and record the impact of therapy on severe mental health conditions through the use of clinical assessment measures. In this article, I propose to extend outcome evaluation by measuring service use and cost prior to and during the commencement of psychological therapy over a period of 4 years for 2 people diagnosed with dissociative identity disorder. The treatment was provided within an outpatient setting in a U.K. National Health Service hospital trust following therapeutic guidelines set out by the International Society for the Study of Trauma and Dissociation. Results show that service use in both inpatient and out-of-hours crisis services reduced as the 2 people received therapy over the 4-year time period. Based on these 2 cases, it appears to be cost effective to provide specialized therapy for dissociative identity disorder in outpatient settings.

Dissociative disorders in DSM-5.

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Spiegel, David; Lewis-Fernández, Roberto; Lanius, Ruth; Vermetten, Eric; Simeon, Daphne; Friedman, Matthew

2013-01-01

The rationale, research literature, and proposed changes to the dissociative disorders and conversion disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are presented. Dissociative identity disorder will include reference to possession as well as identity fragmentation, to make the disorder more applicable to culturally diverse situations. Dissociative amnesia will include dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia but does not always include confused wandering or loss of personality identity. Depersonalization disorder will include derealization as well, since the two often co-occur. A dissociative subtype of posttraumatic stress disorder (PTSD), defined by the presence of depersonalization or derealization in addition to other PTSD symptoms, is being recommended, based upon new epidemiological and neuroimaging evidence linking it to an early life history of adversity and a combination of frontal activation and limbic inhibition. Conversion disorder (functional neurological symptom disorder) will likely remain with the somatic symptom disorders, despite considerable dissociative comorbidity.

Women With Dissociative Identity Disorder Who Experience Intimate Partner Violence.

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Snyder, Briana L

2018-05-01

Women with dissociative identity disorder (DID) are significantly more likely than other women to experience intimate partner violence (IPV). The purpose of this qualitative investigation was to explicate the experiences of women with DID who experience IPV and describe how they cope. Grounded theory was used to conduct this investigation. Purposive sampling was used to recruit participants (N = 5) for face-to-face, semi-structured interviews. Verbatim transcripts were coded and categorized, and reflective memos were developed to explicate substantive categories. Women with DID used coping strategies that were consistent with their diagnoses, such as switching and dissociating. These coping mechanisms reflect past self-preservation strategies that were developed in association with severe childhood maltreatment. Women with DID who experienced IPV sought to mitigate and safeguard themselves from danger using strategies they developed as maltreated children. Nurses can use these findings to better recognize and understand the motivations and behaviors of women with DID who experience IPV. [Journal of Psychosocial Nursing and Mental Health Services, 56(5), 26-32.]. Copyright 2018, SLACK Incorporated.

The butler(s) DID it - dissociative identity disorder in cinema.

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Byrne, P

2001-06-01

Beginning with classic Hollywood melodramas of the 1940s, cinema has maintained a prolific output of films with their own take on mental illnesses-none more so than the rare syndrome of dissociative identity disorder (DID). DID films are a popular and enduring genre, whose influence can be seen throughout mainstream cinema. Exploration of DID in cinema is a useful exercise in that it touches on issues in film studies, psychiatry and the mythology around mental illness. Despite "detective story" narratives and conformity to the codes of the psychological thriller, DID representations correspond closely to contemporary thinking about its phenomenology and aetiology. That said, some films confuse DID with schizophrenia, and many reinforce two other misconceptions within film psychiatry: mental illness as violence and the belief that every mentally ill person harbours one "great dark secret". Those sceptical about DID have suggested that popular written accounts increase its profile: so too, powerful cinematic images may suggest the possibility of DID to susceptible people, including clinicians. Recent DID films reflect the real debate within psychiatry about the diagnostic validity and scientific basis of DID.

Is it Trauma- or Fantasy-based? Comparing dissociative identity disorder, post-traumatic stress disorder, simulators, and controls.

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Vissia, E M; Giesen, M E; Chalavi, S; Nijenhuis, E R S; Draijer, N; Brand, B L; Reinders, A A T S

2016-08-01

The Trauma Model of dissociative identity disorder (DID) posits that DID is etiologically related to chronic neglect and physical and/or sexual abuse in childhood. In contrast, the Fantasy Model posits that DID can be simulated and is mediated by high suggestibility, fantasy proneness, and sociocultural influences. To date, these two models have not been jointly tested in individuals with DID in an empirical manner. This study included matched groups [patients (n = 33) and controls (n = 32)] that were compared on psychological Trauma and Fantasy measures: diagnosed genuine DID (DID-G, n = 17), DID-simulating healthy controls (DID-S, n = 16), individuals with post-traumatic stress disorder (PTSD, n = 16), and healthy controls (HC, n = 16). Additionally, personality-state-dependent measures were obtained for DID-G and DID-S; both neutral personality states (NPS) and trauma-related personality states (TPS) were tested. For Trauma measures, the DID-G group had the highest scores, with TPS higher than NPS, followed by the PTSD, DID-S, and HC groups. The DID-G group was not more fantasy-prone or suggestible and did not generate more false memories. Malingering measures were inconclusive. Evidence consistently supported the Trauma Model of DID and challenges the core hypothesis of the Fantasy Model. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The theory of gender identity disorders.

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Meyer, J K

1982-01-01

Experience with more than 500 patients over the last decade has led to the conclusion that the quest for sex reassignment is a symptomatic compromise formation serving defensive and expressive functions. The symptoms are the outgrowth of developmental trauma affecting body ego and archaic sense of self and caused by peculiar symbiotic and separation-individuation phase relationships. The child exists in the pathogenic (and reparative) maternal fantasy in order to repair her body image and to demonstrate the interconvertability of the sexes. Gender identity exists not as a primary phenomenon, but in a sense as a tertiary one. There is, no doubt, a tendency to gender-differentiate in a way concordant with biological endowment. Nevertheless, gender formation is seriously compromised by earlier psychological difficulty. Gender identity is a fundamental acquisition in the developing personality, but it is part of a hierarchical series beginning with archaic body ego, early body image, and primitive selfness, representing their extension into sexual and reproductive spheres. Gender identity consolidates during separation-individuation and gender pathology bears common features with other preoedipal syndromes. Transsexualism is closely linked to perversions, and the clinical syndromes may shade from one into another. However, what is kept at the symbolic level in the perversions must be made concrete in transsexualism. In this regard there is a close relation to psychosis. The clinical complaint of the transsexual is a condensation of remarkable proportions. When the transsexual says that he is a girl trapped in a man's body, he sincerely means what he says. As with other symptoms, however, it takes a long time before he begins to say what he means.

An eye for an I: a 35-year-old woman with fluctuating oculomotor deficits and dissociative identity disorder.

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Bhuvaneswar, Chaya; Spiegel, David

2013-01-01

Physiologic changes, including neurological or pseudo-neurological symptoms, occur across identity states in dissociative identity disorder DID) and can be objectively measured. The idea that dissociative phenomena might be associated with changes in brain function is consistent with research on the brain effects of hypnosis. The authors report a case of psycho-physiologic differences among 4 alter personalities manifested by a 35-year-old woman with DID. Differences in visual acuity, frequency of pendular nystagmus, and handedness were observed in this patient both when the alter personalities appeared spontaneously and when elicited under hypnosis. The authors consider several diagnostic possibilities for these findings and discuss whether prevailing treatment recommendations for DID patients could possibly be modified to ameliorate such visual and neurologic symptoms.

Gender Identity in Patients with Congenital Adrenal Hyperplasia.

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Razzaghy-Azar, Maryam; Karimi, Sakineh; Shirazi, Elham

2017-07-01

Sex assignment in infancy for patients with disorder of sex development (DSD) is a challenging problem. Some of the patients with congenital adrenal hyperplasia (CAH) have DSD that may affect their gender identity. The study aimed to assess gender identity in patients with CAH. In this study, 52 patients with CAH, including 22 prepubertal children and 30 adolescents and adults, were assessed using two separate gender identity questionnaires for children and adults based on the criteria of diagnostic and statistical manual of mental disorders, 5th edition. In the children group, compatibility was seen between gender identity and rearing gender. In the adult group, there were three cases of mismatching between gender identity and sex assignment composed of two females with poor control and one male with good control with 21-hydroxylase deficiency (21-OHD). Three girls with 11-hydroxylase deficiency (11-OHD) were reared as boy. Two of them with late diagnosis at 5 and 6 years of age had pseudoprecocious puberty. Parents and children did not accept to change the gender. One of them is 36 years old now, is depressed and unsatisfied with her gender, another girl is still child and has male sexual identity. One girl with 11-OHD and early diagnosis at birth with Prader 5 virilization but with good hormonal control was changed to female gender at 12 years of age when female sexual characteristics appeared; she is 34-years-old now, married, and with two children, and she is satisfied with her gender. In patients with CAH, gender identity disorder is a rare finding. Hormonal control, social, familial, and religious beliefs have impacts on gender identity of these patients.

Apparent Amnesia : interidentity memory functioning in dissociative identity disdorder

NARCIS (Netherlands)

Huntjens, R.J.C.

2003-01-01

Dissociative identity disorder (DID) is characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual s behavior. Between 95 and 100 % of DID patients report experiences of blank spells for periods of time when other identities

Self-reported sleep disturbances in patients with Dissociative Identity Disorder and Post-Traumatic Stress Disorder and how they relate to cognitive failures and fantasy proneness

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Dalena eVan Heugten - Van Der Kloet

2014-02-01

Full Text Available Sleep disturbances, fantasy proneness, cognitive failures, and dissociative symptoms are related to each other. However, the co-occurrence of these phenomena has been primarily studied in non-clinical samples. We investigated the correlations between these phenomena in dissociative identity disorder patients, post-traumatic stress disorder patients, and healthy controls. Both patient groups reported more sleep problems and lower sleep quality and displayed higher levels of fantasy proneness and cognitive failures than controls. However, the two patient groups did not differ with regard to these variables. Moreover, a higher level of unusual sleep experiences tended to predict participants belonging to the DID group, while specifically a lower sleep quality and more cognitive failures tended to predict participants belonging to the PTSD group.

Self-reported sleep disturbances in patients with dissociative identity disorder and post-traumatic stress disorder and how they relate to cognitive failures and fantasy proneness.

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van Heugten-van der Kloet, Dalena; Huntjens, Rafaele; Giesbrecht, Timo; Merckelbach, Harald

2014-01-01

Sleep disturbances, fantasy proneness, cognitive failures, and dissociative symptoms are related to each other. However, the co-occurrence of these phenomena has been primarily studied in non-clinical samples. We investigated the correlations between these phenomena in dissociative identity disorder (DID) patients, post-traumatic stress disorder (PTSD) patients, and healthy controls. Both patient groups reported more sleep problems and lower sleep quality and displayed higher levels of fantasy proneness and cognitive failures than controls. However, the two patient groups did not differ with regard to these variables. Moreover, a higher level of unusual sleep experiences tended to predict participants belonging to the DID group, while specifically a lower sleep quality and more cognitive failures tended to predict participants belonging to the PTSD group.

The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

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Blom, Rianne M; van Wingen, Guido A; van der Wal, Sija J; Luigjes, Judy; van Dijk, Milenna T; Scholte, H Steven; Denys, D.

2016-01-01

BACKGROUND: Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but evidence for a neuro-anatomical basis is sparse. METHODS: We collected T1-weighted structural magnetic resonance imaging scans on a 3T scanner in eight individuals with BIID and 24 matched healthy c...

A critical view of transgender health care in Germany: Psychopathologizing gender identity - Symptom of 'disordered' psychiatric/psychological diagnostics?

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Güldenring, Annette

2015-01-01

After explaining the essential trans* terminology, I offer a short historical overview of the way health care has dealt with the subject of gender, trans* and health in different times. In the third section, I compare the world's most important diagnostic manuals, namely the International statistical classification of diseases and related health problems (ICD) and the Diagnostic and statistical manual of mental disorders (DSM), i.e. their criteria for 'gender identity disorders' (ICD-10) and 'gender dysphoria' (DSM-5). The fourth section branch out the factors which influence every diagnostic conception - of no matter whom - in the health care system. The last section discusses the implications resulting from this diagnostic dilemma for the health situation of gender nonconforming people.

Return to work: a case of PTSD, dissociative identity disorder, and satanic ritual abuse.

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Precin, Patricia

2011-01-01

This case study investigated an intervention that enabled an individual with Posttraumatic Stress Disorder (PTSD), Dissociative Identity Disorder (DID), and satanic ritual abuse to return to work after discharge from psychiatric inpatient treatment. The Occupational Questionnaire [88] revealed past difficulties in organization, awareness of time, communication, cooperation, frustration tolerance, competition, stress management, goal setting, and amnesia resulting in incomplete tasks and sporadic attendance at work. The Role Checklist [72] identified alters valuing work and employed in the past. The Modified Interest Checklist [70] identified running as an interest that 24 alters shared. Based on the initial evaluations, three times a week treadmill running was used as an intervention that built work skills (as measured by the Clerical Work Sample of the Valpar Component Work Sample Series [97]) necessary to sustain gainful employment upon discharge. After intervention, this individual improved in awareness of time, stress management, and goal setting abilities and was less amnestic as per the Occupational Questionnaire [88] and four additional alters expressed an interest in work according to the Modified Interest Checklist [70].

Recent reports on dissociative identity disorder

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Maria Golebiowska

2017-09-01

Unfortunately, due to the length of the treatment processes, which last for the whole life of the patient, its hard to identify the cases with full integration of identity and full recovery. As a conclusion, authors define DID as an important issue in modern psychiatry which should be further addressed in neurobiological and pharmacological studies.

[Puberty-delaying hormone therapy in adolescents with gender identity disorder].

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Nakatsuka, Mikiya

2013-01-01

The guideline for the treatment of people with gender identity disorder (GID) of the Japanese Society of Psychiatry and Neurology was revised in January 2012. The guideline eased restrictions for the endocrine treatment of transsexual adolescents. A medical specialist can start treating transsexual adolescents at the age of 15 after the diagnosis of GID. It recommends that transsexual adolescents (Tanner stage 2 [mainly 12-13 years of age]) are treated by endocrinologists to suppress puberty with gonadotropin-releasing hormone (GnRH) agonists until the age of 15 years old, after which cross-sex hormones may be given. Female-to-male transsexuals do not necessarily want to start androgen therapy before presenting female secondary sexual characteristics because androgen can easily stop menstruation, cause beard growth, and lower the voice. On the contrary, male-to-female transsexuals want to start estrogen therapy before presenting male secondary sexual characteristics because estrogen cannot alter the beard and low voice. It is important to identify children with gender dysphoria in school and help them receive medical advice. However, approximately half of school teachers think that children with gender dysphoria are very rare and they do not know of the notification from Ministry of Education, Culture, Sports, Science and Technology, JAPAN, which aims to help children with gender dysphoria. The revision of the guideline for the treatment of transsexual people and endocrine treatment of transsexual adolescents by medical specialists may prevent them from attempting suicide, being depressive, and refusing to attend school. Furthermore, the treatment may help avoid mental disorders, aid being employed with the desired sexuality, and, subsequently, getting married and having children.

Navigating Undiagnosed Dissociative Identity Disorder in the Inpatient Setting: A Case Report.

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Urbina, Theresa M; May, Tania; Hastings, Michelle

2017-05-01

This case illustrates previously undiagnosed dissociative identity disorder (DID) in a middle-aged female with extensive childhood trauma, who was high functioning prior to a trigger that caused a reemergence of her symptoms. The trigger sparked a dissociative state, attempted suicide, and subsequent inpatient psychiatric hospitalization. Practitioners should include in their differential and screen for undiagnosed DID in patients with episodic psychiatric hospitalizations refractory to the standard treatments for previously diagnosed mental illnesses. Case study. During hospitalization, the diagnosis of DID became apparent and treatment included low-dose risperidone, mirtazapine, sertraline, unconditional positive regard, normalization of her dissociative states in an attempt to decrease her anxiety during treatment, and documentation for the patient via written notes following interviews. These methods helped her come to terms with the diagnosis and allowed the treatment team to teach her coping skills to lessen the impact of dissociative states following discharge.

Visual Scan Paths and Recognition of Facial Identity in Autism Spectrum Disorder and Typical Development

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Wilson, C. Ellie; Palermo, Romina; Brock, Jon

2012-01-01

Background Previous research suggests that many individuals with autism spectrum disorder (ASD) have impaired facial identity recognition, and also exhibit abnormal visual scanning of faces. Here, two hypotheses accounting for an association between these observations were tested: i) better facial identity recognition is associated with increased gaze time on the Eye region; ii) better facial identity recognition is associated with increased eye-movements around the face. Methodology and Principal Findings Eye-movements of 11 children with ASD and 11 age-matched typically developing (TD) controls were recorded whilst they viewed a series of faces, and then completed a two alternative forced-choice recognition memory test for the faces. Scores on the memory task were standardized according to age. In both groups, there was no evidence of an association between the proportion of time spent looking at the Eye region of faces and age-standardized recognition performance, thus the first hypothesis was rejected. However, the ‘Dynamic Scanning Index’ – which was incremented each time the participant saccaded into and out of one of the core-feature interest areas – was strongly associated with age-standardized face recognition scores in both groups, even after controlling for various other potential predictors of performance. Conclusions and Significance In support of the second hypothesis, results suggested that increased saccading between core-features was associated with more accurate face recognition ability, both in typical development and ASD. Causal directions of this relationship remain undetermined. PMID:22666378

Assessment of identity development and identity diffusion in adolescence - Theoretical basis and psychometric properties of the self-report questionnaire AIDA

Directory of Open Access Journals (Sweden)

Goth Kirstin

2012-07-01

Full Text Available Abstract Background In the continuing revision of Diagnostic and Statistical Manual (DSM-V “identity” is integrated as a central diagnostic criterion for personality disorders (self-related personality functioning. According to Kernberg, identity diffusion is one of the core elements of borderline personality organization. As there is no elaborated self-rating inventory to assess identity development in healthy and disturbed adolescents, we developed the AIDA (Assessment of Identity Development in Adolescence questionnaire to assess this complex dimension, varying from “Identity Integration” to “Identity Diffusion”, in a broad and substructured way and evaluated its psychometric properties in a mixed school and clinical sample. Methods Test construction was deductive, referring to psychodynamic as well as social-cognitive theories, and led to a special item pool, with consideration for clarity and ease of comprehension. Participants were 305 students aged 12–18 attending a public school and 52 adolescent psychiatric inpatients and outpatients with diagnoses of personality disorders (N = 20 or other mental disorders (N = 32. Convergent validity was evaluated by covariations with personality development (JTCI 12–18 R scales, criterion validity by differences in identity development (AIDA scales between patients and controls. Results AIDA showed excellent total score (Diffusion: α = .94, scale (Discontinuity: α = .86; Incoherence: α = .92 and subscale (α = .73-.86 reliabilities. High levels of Discontinuity and Incoherence were associated with low levels in Self Directedness, an indicator of maladaptive personality functioning. Both AIDA scales were significantly different between PD-patients and controls with remarkable effect sizes (d of 2.17 and 1.94 standard deviations. Conclusion AIDA is a reliable and valid instrument to assess normal and disturbed identity in adolescents. Studies for further

Significance of gender identity (the case of transsexualism) in Canon law

OpenAIRE

Meilius, Kazimieras; Juškevičius, Jonas; Širinskienė, Agnė

2015-01-01

Transsexualism is a gender identity disorder that is defined by the ICD-10 Classification of Mental and Behavioural Disorders as a “desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make one’s body as congruent as possible with one’s preferred sex through surgery and hormonal treatment”. Gender identity disorder, especially after a surgical operation has been performed in order to achieve the desired sex of a transsexual, can create serious pro...

The DSM diagnostic criteria for gender identity disorder in adolescents and adults.

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Cohen-Kettenis, Peggy T; Pfäfflin, Friedemann

2010-04-01

Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by similarities and differences of the terms transsexualism and GID, the inability of the current criteria to capture the whole spectrum of gender variance phenomena, the potential risk of unnecessary physically invasive examinations to rule out intersex conditions (disorders of sex development), the necessity of the D criterion (distress and impairment), and the fact that the diagnosis still applies to those who already had hormonal and surgical treatment. If the diagnosis should not be deleted from the DSM, most of the criticism could be addressed in the DSM-V if the diagnosis would be renamed, the criteria would be adjusted in wording, and made more stringent. However, this would imply that the diagnosis would still be dichotomous and similar to earlier DSM versions. Another option is to follow a more dimensional approach, allowing for different degrees of gender dysphoria depending on the number of indicators. Considering the strong resistance against sexuality related specifiers, and the relative difficulty assessing sexual orientation in individuals pursuing hormonal and surgical interventions to change physical sex characteristics, it should be investigated whether other potentially relevant specifiers (e.g., onset age) are more appropriate.

Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder.

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Chalavi, Sima; Vissia, Eline M; Giesen, Mechteld E; Nijenhuis, Ellert R S; Draijer, Nel; Barker, Gareth J; Veltman, Dick J; Reinders, Antje A T S

2015-03-30

Neuroanatomical evidence on the relationship between posttraumatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The relationship of gender and gender identity to treatment adherence among individuals with bipolar disorder.

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Sajatovic, Martha; Micula-Gondek, Weronika; Tatsuoka, Curtis; Bialko, Christopher

2011-08-01

It has been demonstrated that 46% to 48% of individuals with bipolar disorder (BD) are at least partially nonadherent with prescribed medication. Reports of whether male gender is a predictor of treatment nonadherence in BD have been inconsistent. The construct of gender may also be a matter of cultural orientation, and psychological gender, as a component of self-perception, may affect the experience of mental illness. Gender identity is the subjective experience of one's individuality as male or female. This cross-sectional study evaluated gender and gender identity among men and women with BD as they relate to self-reported medication treatment adherence. This secondary analysis of a larger study on treatment adherence evaluated men and women with BD being treated with mood-stabilizing medications in a community mental health clinic. Gender identity and treatment adherence were evaluated using the Bem Sex Role Inventory (BSRI) and the Tablets Routine Questionnaire, respectively. Other measures included assessing BD symptoms using the Hamilton Depression Rating Scale and mania symptoms using the Young Mania Rating Scale, as well as psychosocial support with the Interpersonal Support Evaluation List and locus of control with the Multidimensional Health Locus of Control Scale. Mean age of the 70 men and 70 women with type I BD was 43.1 years for adherent patients and 40.8 years for nonadherent patients. Women with BD had mean scores on the BSRI consistent with general population norms, whereas men with BD had scores suggesting lower levels of self-perceived masculinity than population norms. There were no differences between men and women on adherence; however, men with high BSRI masculinity scores had less adherence than other men in the sample (P = 0.04). Lower scores on the "powerful others" dimension of locus of control were associated with lower adherence. For women, there was no relationship between BSRI masculinity scores and adherence. Gender identity in

Body integrity identity disorder crosses culture: case reports in the Japanese and Chinese literature

Directory of Open Access Journals (Sweden)

Blom RM

2016-06-01

Full Text Available Rianne M Blom,1 Nienke C Vulink,1 Sija J van der Wal,1 Takashi Nakamae,1–3 Zhonglin Tan,1,4 Eske M Derks,1 Damiaan Denys1,5 1Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 2Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 3Department of Neural Computation for Decision-Making, ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan; 4Department of Psychiatry, Hangzhou Mental Health Center, Hangzhou, People’s Republic of China; 5Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands Abstract: Body integrity identity disorder (BIID is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only Western patients with BIID, suggesting that the disorder might be merely prevalent in the West. To scrutinize this assumption, and to extend our knowledge of the etiology of BIID, it is important to trace cases with BIID in non-Western populations. Our objective was to review Chinese and Japanese literature on BIID to learn about its presence in populations with a different genetic background. A systematic literature search was performed in databases containing Japanese and Chinese research, published in the respective languages. Five Japanese articles of BIID were identified which described two cases of BIID, whereas in the Chinese databases only BIID-related conditions were found. This article reports some preliminary evidence that BIID is also present in non-Western countries. However, making general statements about the biological background of the disorder is hampered by the extremely low number of cases found. This low number possibly resulted from the extreme secrecy

Gender identity development in adolescence.

Science.gov (United States)

Steensma, Thomas D; Kreukels, Baudewijntje P C; de Vries, Annelou L C; Cohen-Kettenis, Peggy T

2013-07-01

This article is part of a Special Issue "Puberty and Adolescence".This article aims to provide an outline of what is currently known on trajectories, and contributing factors to gender identity development in adolescence. We give a historical overview of the concept of gender identity, and describe general identity development in adolescence, gender identity development in the general population and in gender variant youth. Possible psychosocial (such as child and parental characteristics) and biological factors (such as the effects of prenatal exposure to gonadal hormones and the role of genetics) contributing to a gender variant identity are discussed. Studies focusing on a number of psychosocial and biological factors separately, indicate that each of these factors influence gender identity formation, but little is known about the complex interplay between the factors, nor about the way individuals themselves contribute to the process. Research into normative and gender variant identity development of adolescents is clearly lagging behind. However, studies on persons with gender dysphoria and disorders of sex development, show that the period of adolescence, with its changing social environment and the onset of physical puberty, seems to be crucial for the development of a non-normative gender identity. Copyright © 2013 Elsevier Inc. All rights reserved.

Testing the diagnosis of dissociative identity disorder through measures of dissociation, absorption, hypnotizability and PTSD: a Norwegian pilot study.

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Dale, Karl Yngvar; Berg, Renate; Elden, Ake; Ødegård, Atle; Holte, Arne

2009-01-01

A total of 14 women meeting criteria for dissociative identity disorder (DID) based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]) were compared to a group of women (n = 10) with other dissociative diagnoses and a group of normal controls (n = 14) with regard to dissociativity, absorption, trauma related symptoms and hypnotizability. Both of the clinical groups reported histories of childhood trauma and attained high PTSD scores. The DID group differed significantly from the group with other dissociative diagnoses and the non-diagnosed comparison group with regard to hypnotizability, the variety of dissociative symptomatology, and the magnitude of dissociative symptomatology. However, no significant differences between the two clinical groups were detected with regard to absorption, general dissociative level, or symptoms related to traumatic stress. Results support the notion that DID can be regarded as a clinical entity which is separable from other dissociative disorders. Results also indicated that hypnotizability is the most important clinical feature of DID.

Cross-sex hormone treatment does not change sex-sensitive cognitive performance in gender identity disorder patients.

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Haraldsen, Ira R; Egeland, Thore; Haug, Egil; Finset, Arnstein; Opjordsmoen, Stein

2005-12-15

Cognitive performance in untreated early onset gender identity disorder (GID) patients might correspond to their born sex and not to their perceived gender. As a current mode of intervention, cross-sex hormone treatment causes considerable physical changes in GID patients. We asked, as has been suggested, whether this treatment skews cognitive performance towards that of the acquired sex. Somatically healthy male and female early onset GID patients were neuropsychologically tested before, 3 and 12 months after initiating cross-sex hormone treatment, whereas untreated healthy subjects without GID served as controls (C). Performance was assessed by testing six cognitive abilities (perception, arithmetic, rotation, visualization, logic, and verbalization), and controlled for age, education, born sex, endocrine differences and treatment by means of repeated measures analysis of variance. GID patients and controls showed an identical time-dependent improvement in cognitive performance. The slopes were essentially parallel for males and females. There was no significant three-way interaction of born sex by group by time for the six investigated cognitive abilities. Only education and age significantly influenced this improvement. Despite the substantial somatic cross-sex changes in GID patients, no differential effect on cognition over time was found between C and GID participants. The cognitive performance of cross-sex hormone-treated GID patients was virtually identical to that of the control group. The documented test-retest effect should be taken into consideration when evaluating treatment effects generally in psychiatry.

[Transference in the treatment of dissociative identity disorder: A review of literature and a case example].

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Lambert, Ann Marie; Gagnon, Lise; Fontaine, Francine S

2014-01-01

A literature review about transference in the treatment of dissociative identity disorder (DID) is presented. Common transference reactions resulting from serious traumas are explored, considering that those kind of trauma are higly present in the pathways of DID patients. Post traumatic transference aspects specific to DID are also presented. In addition, common transference patterns and dissociative aspects of transference in the treatment of DID are explained. Transference is also discussed in relationship to the possible impact of disorganized attachment, which is a main component in the development of DID. The clinical implications of this proposition will be discussed and supported by a case example.

Internalized Racism and Past-Year Major Depressive Disorder Among African-Americans: the Role of Ethnic Identity and Self-Esteem.

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James, Drexler

2017-08-01

Although a large body of research focuses on discrimination as a risk for depression among African-Americans, only a dearth of research focuses on internalized racism (i.e., endorsement of negative stereotypes of one's racial group) as a risk factor. In addition, no studies have yet to examine mediators and/or moderators of the relationship between internalized racism and depression. To this end, the present study examined the mediating and moderating roles of (a) self-esteem and (b) ethnic identity on the relationship between internalized racism and past-year major depressive disorder (MDD), in a nationally representative sample of African-American adults (N = 3570) from the National Survey of American Life. Results from this study revealed an indirect association between internalized racism and past-year MDD via self-esteem, but no indirect relationship via ethnic identity. Further, results show that both self-esteem and ethnic identity individually moderate the relationship between internalized racism and past-year MDD. Collectively, these findings suggest a need to further investigate mechanisms through which internalized racism impacts mental health and factors that strengthen and/or weaken the association between internalized racism and depression.

Substance abuse as a way of life in marginalized gender identity disorder: a case report with review of Indian literature.

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Goyal, Shrigopal; Deb, Koushik Sinha; Elawadhi, Deeksha; Kaw, Nanaji

2014-12-01

Persons suffering from gender identity disorder (GID) are often severely marginalized in India and mostly live outside the society as a part of a minority community called the Hijras. Although substance abuse is considered a way of life in them, such patients rarely seek treatment because of the stigma and fear of discrimination. We report a case of GID presenting to tertiary care centre for treatment of multiple substance use dependence (SUD). The case is the first to highlight the use and dependence of multiple substances in the Hijra community of India. Further, the case emphasizes that SUD treatment might be a worthwhile intervention to bring such marginalized population under treatment, when further complicated issues on gender identity can be addressed. Copyright © 2014. Published by Elsevier B.V.

ALIGNING THE BRAND IDENTITY AND BRAND IMAGE AFTER REBRANDING

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Cătălin Mihail BARBU

2016-11-01

Full Text Available The brand identity and brand image are two concepts used extensively in positioning. Many brands underwent a rebranding process attempting to improve their positioning. The rebranding process can bring minor changes or substantial changes. Following the substantial changes, there can appear a mismatch between the desired identity and brand image. Brand image is persistent and it takes time to change it. This paper explores the challenges involved by the calibration of the identity and of the image in the process of rebranding. The alignment process is a dynamic one, an interactive and not a normative one. The results of this study highlight the elements that support the brand identity and image alignment: marketing communication, product characteristics and internal brand strength. On the other side, the efforts to align the brand identity and brand image are negatively affected by the attitudes of the consumers and their past experience with the brand.

Perceiving a negative event as central to one's identity partially mediates age differences in posttraumatic stress disorder symptoms.

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Boals, Adriel; Hayslip, Bert; Knowles, Laura R; Banks, Jonathan B

2012-04-01

Older adults report fewer posttraumatic stress disorder (PTSD) symptoms than younger adults, but the reasons for this age difference are unclear. In the current study, the authors explored the extent to which they may be due to age differences in event centrality (the extent to which a person construes a stressful event as central to their identity). A sample of older and younger adults nominated their most stressful event and completed measures of PTSD symptoms and event centrality. The results revealed that older adults were less likely to construe a stressful event as central to identity, even after controlling for type of event, how long ago the event occurred, and gender. In addition, the results of a mediation analysis indicated that age-related differences in event centrality partially mediated age-related differences in PTSD symptoms. The results are consistent with the Socioemotional Selectivity Theory view that older adults tend to use cognitive strategies designed to protect emotional health.

Predicting stabilizing treatment outcomes for complex posttraumatic stress disorder and dissociative identity disorder: an expertise-based prognostic model.

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Baars, Erik W; van der Hart, Onno; Nijenhuis, Ellert R S; Chu, James A; Glas, Gerrit; Draijer, Nel

2011-01-01

The purpose of this study was to develop an expertise-based prognostic model for the treatment of complex posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). We developed a survey in 2 rounds: In the first round we surveyed 42 experienced therapists (22 DID and 20 complex PTSD therapists), and in the second round we surveyed a subset of 22 of the 42 therapists (13 DID and 9 complex PTSD therapists). First, we drew on therapists' knowledge of prognostic factors for stabilization-oriented treatment of complex PTSD and DID. Second, therapists prioritized a list of prognostic factors by estimating the size of each variable's prognostic effect; we clustered these factors according to content and named the clusters. Next, concept mapping methodology and statistical analyses (including principal components analyses) were used to transform individual judgments into weighted group judgments for clusters of items. A prognostic model, based on consensually determined estimates of effect sizes, of 8 clusters containing 51 factors for both complex PTSD and DID was formed. It includes the clusters lack of motivation, lack of healthy relationships, lack of healthy therapeutic relationships, lack of other internal and external resources, serious Axis I comorbidity, serious Axis II comorbidity, poor attachment, and self-destruction. In addition, a set of 5 DID-specific items was constructed. The model is supportive of the current phase-oriented treatment model, emphasizing the strengthening of the therapeutic relationship and the patient's resources in the initial stabilization phase. Further research is needed to test the model's statistical and clinical validity.

Cultural identity, clothing and common mental disorder: a prospective school-based study of white British and Bangladeshi adolescents.

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Bhui, K; Khatib, Y; Viner, R; Klineberg, E; Clark, C; Head, J; Stansfeld, S

2008-05-01

Cultural integration is the healthiest outcome for young people living in multicultural societies. This paper investigates the influence of different cultural identities on the risk of common mental disorders among Bangladeshi and white British pupils. The cultural identity of 11-14-year-old school pupils was assessed by their preferences for friends and clothes of their own or other cultural groups; using this information pupils were classified into traditional, integrated, assimilated or marginalised groups. We undertook prospective analyses of cultural identity and its impacts on the later mental health of young people. East London. In 2001, white British (573) and Bangladeshi (682) school pupils from a representative sample of schools completed a self-report questionnaire that assessed their cultural, social and health characteristics. In 2003, 383 white British and 517 Bangladeshi pupils were resurveyed and completed measures of mental health. Strengths and difficulties questionnaire. Bangladeshi pupils preferring clothes from their own cultural group (traditional clothing) were less likely to have later mental health problems when compared with Bangladeshi pupils showing an equal preference for clothing from their own and other cultures (integrated clothing; odds ratio (OR) 0.3, 95% CI 0.1 to 0.9). In gender-specific analyses, this finding was sustained only among Bangladeshi girls (OR 0.1, 95% CI 0.1 to 0.7). Integrated clothing choices were least risky only for white British adolescents. Friendship choices showed no prospective associations with later mental health problems. Cultural identity, expressed by clothing preferences, influences mental health; the effects differ by gender and ethnic group.

Adolescent identity development and distress in a clinical sample.

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Wiley, Rachel E; Berman, Steven L

2013-12-01

The purpose of this study was to examine the relationships of identity development and identity distress to psychological adjustment within adolescents affected by psychological problems. Participants included 88 adolescents (43.2% female) ranging from 11 to 20 years of age who were receiving services from a community mental health center. A high proportion of the participants (22.7%) met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision criteria for Identity Problem. Regression analyses found psychopathology symptom score was associated with identity distress, identity exploration, and identity commitment, while identity distress was only related to psychopathology symptom score and not the other two identity variables. Adolescents with a clinical diagnosis may report significant levels of identity distress. Given that the relationship between psychopathology and identity distress may be reciprocal, assessing for identity issues might be prudent when conducting clinical diagnostic interviews and useful in treatment planning. © 2013 Wiley Periodicals, Inc.

MMPI-2 Item Endorsements in Dissociative Identity Disorder vs. Simulators.

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Brand, Bethany L; Chasson, Gregory S; Palermo, Cori A; Donato, Frank M; Rhodes, Kyle P; Voorhees, Emily F

2016-03-01

Elevated scores on some MMPI-2 (Minnesota Multiphasic Inventory-2) validity scales are common among patients with dissociative identity disorder (DID), which raises questions about the validity of their responses. Such patients show elevated scores on atypical answers (F), F-psychopathology (Fp), atypical answers in the second half of the test (FB), schizophrenia (Sc), and depression (D) scales, with Fp showing the greatest utility in distinguishing them from coached and uncoached DID simulators. In the current study, we investigated the items on the MMPI-2 F, Fp, FB, Sc, and D scales that were most and least commonly endorsed by participants with DID in our 2014 study and compared these responses with those of coached and uncoached DID simulators. The comparisons revealed that patients with DID most frequently endorsed items related to dissociation, trauma, depression, fearfulness, conflict within family, and self-destructiveness. The coached group more successfully imitated item endorsements of the DID group than did the uncoached group. However, both simulating groups, especially the uncoached group, frequently endorsed items that were uncommonly endorsed by the DID group. The uncoached group endorsed items consistent with popular media portrayals of people with DID being violent, delusional, and unlawful. These results suggest that item endorsement patterns can provide useful information to clinicians making determinations about whether an individual is presenting with DID or feigning. © 2016 American Academy of Psychiatry and the Law.

Apparent Amnesia : interidentity memory functioning in dissociative identity disdorder

OpenAIRE

Huntjens, R.J.C.

2003-01-01

Dissociative identity disorder (DID) is characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual s behavior. Between 95 and 100 % of DID patients report experiences of blank spells for periods of time when other identities are in control of their behavior. In this thesis, the fundamental question of whether objective evidence for the reported interidentity amnesia in DID can be found under rigorous experimental cond...

An Overwhelming Desire to Be Blind: Similarities and Differences between Body Integrity Identity Disorder and the Wish for Blindness

OpenAIRE

Katja Gutschke; Aglaja Stirn; Erich Kasten

2017-01-01

Background: The urge to be permanently blind is an extremely rare mental health disturbance. The underlying cause of this desire has not been determined yet, and it is uncertain whether the wish for blindness is a condition that can be included in the context of body integrity identity disorder, a condition where people feel an overwhelming need to be disabled, in many cases by amputation of a limb or through paralysis. Objective: The aim of this study is to test the hypothesis that people wi...

Interpellating recovery: The politics of 'identity' in recovery-focused treatment.

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Fomiatti, Renae; Moore, David; Fraser, Suzanne

2017-06-01

Much research tends to treat alcohol and other drug 'recovery' as a process of positive identity change and development. In this article, we depart from this dominant approach by examining how the social and material practices of alcohol and other drug treatment are themselves active in the constitution of 'recovery identity'. Using Judith Butler's theorisation of interpellation, we examine the accounts of treatment experiences and practices provided in interviews with people who inject drugs. In contrast to the existing literature, we argue that the 'recovering addict' is a socially produced category rather than a coherent psychological identity. We consider the production of this category in relation to three dynamics identified in the data: (1) the tendency to materialise treatment subjects as both disordered and as 'in control' of these disorders; (2) the production of treatment subjects as enmeshed in suspect social relationships and therefore requiring surveillance as well as social support; and (3) treatment's particular enactment of social context such that it erases stigmatisation and marginalisation and paradoxically performs subjects as entirely individually responsible for relinquishing drug use. These dynamics produce capacities and attributes often ascribed to identity but which are better understood as articulations of epistemological disorder in the state of knowledge about addiction, and its expression in treatment. By way of conclusion, we question the utility of 'recovery identity', conventionally defined, in providing a rationale for treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Identity Disturbance, Feelings of Emptiness, and the Boundaries of the Schizophrenia Spectrum

DEFF Research Database (Denmark)

Zandersen, Maja; Parnas, Josef

2018-01-01

in schizophrenia and schizotypal personality disorder. Unfortunately, the diagnostic manuals offer limited insight into the nature of these criteria, including possible deviations and similarities with schizophrenia spectrum symptomatology. In this article, we attempt to clarify the concepts of identity......Historical and current research on borderline personality disorder reveal certain affinities with schizophrenia spectrum psychopathology. This is also the case for the borderline criteria of "identity disturbance" and "feelings of emptiness," which reflect symptomatology frequently found...

Lives in a chiaroscuro. Should we suspend the puberty of children with gender identity disorder?

Science.gov (United States)

Giordano, S

2008-08-01

Transgender children who are not treated for their condition are at high risk of violence and suicide. As a matter of survival, many are willing to take whatever help is available, even if this is offered by illegal sources, and this often traps them into the juvenile criminal system and exposes them to various threats. Endocrinology offers a revolutionary instrument to help children/adolescents with gender identity disorder: suspension of puberty. Suspension of puberty raises many ethical issues, and experts dissent as to when treatment should be commenced and how children should be followed up. This paper argues that suspension of puberty is not only not unethical: if it is likely to improve the child's quality of life and even save his or her life, then it is indeed unethical to defer treatment.

Discrimination, Racial/Ethnic Identity, and Substance Use Among Latina/os: Are They Gendered?

Science.gov (United States)

Molina, Kristine M; Jackson, Benita; Rivera-Olmedo, Noemi

2016-02-01

Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os. The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables. We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder. Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome. Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity.

Global functioning and disability in dissociative disorders.

Science.gov (United States)

Mueller-Pfeiffer, Christoph; Rufibach, Kaspar; Perron, Noelle; Wyss, Daniela; Kuenzler, Cornelia; Prezewowsky, Cornelia; Pitman, Roger K; Rufer, Michael

2012-12-30

Dissociative disorders are frequent comorbid conditions of other mental disorders. Yet, there is controversy about their clinical relevance, and little systematic research has been done on how they influence global functioning. Outpatients and day care patients (N=160) of several psychiatric units in Switzerland were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV Axis I Disorders, Structured Clinical Interview for DSM-IV Dissociative Disorders, Global Assessment of Functioning Scale, and World Health Organization Disability Assessment Schedule-II. The association between subjects with a dissociative disorder (N=30) and functional impairment after accounting for non-dissociative axis I disorders was evaluated by linear regression models. We found a proportion of 18.8% dissociative disorders (dissociative amnesia=0%, dissociative fugue=0.6%, depersonalization disorder=4.4%, dissociative identity disorder=7.5%, dissociative disorder-not-otherwise-specified=6.3%) across treatment settings. Adjusted for other axis I disorders, subjects with a comorbid dissociative identity disorder or dissociative disorder-not-otherwise-specified had a median global assessment of functioning score that was 0.86 and 0.88 times, respectively, the score of subjects without a comorbid dissociative disorder. These findings support the hypothesis that complex dissociative disorders, i.e., dissociative identity disorder and dissociative disorder-not-otherwise-specified, contribute to functional impairment above and beyond the impact of co-existing non-dissociative axis I disorders, and that they qualify as "serious mental illness". Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Distinguishing simulated from genuine dissociative identity disorder on the MMPI-2.

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Brand, Bethany L; Chasson, Gregory S

2015-01-01

Due to high elevations on validity and clinical scales on personality and forensic measures, it is challenging to determine if individuals presenting with symptoms of dissociative identity disorder (DID) are genuine or not. Little research has focused on malingering DID, or on the broader issue of the profiles these patients obtain on the Minnesota Multiphasic Personality Inventory (MMPI-2), despite increasing awareness of dissociation. This study sought to characterize the MMPI-2 profiles of DID patients and to determine the utility of the MMPI-2 in distinguishing DID patients from uncoached and coached DID simulators. The analyses revealed that Infrequency, Back Infrequency, and Infrequency-Psychopathology (Fp) distinguished simulators from genuine DID patients. Fp was best able to discriminate simulated DID. Utility statistics and classification functions are provided for classifying individual profiles as indicative of genuine or simulated DID. Despite exposure to information about DID, the simulators were not able to accurately feign DID, which is inconsistent with the iatrogenic/sociocultural model of DID. Given that dissociation was strongly associated with elevations in validity, as well as clinical scales, including Scale 8 (i.e., Schizophrenia), considerable caution should be used in interpreting validity scales as indicative of feigning, and Scale 8 as indicative of schizophrenia, among highly dissociative individuals. (c) 2015 APA, all rights reserved).

The Pattern of Sexual Interest of Female-to-Male Transsexual Persons With Gender Identity Disorder Does Not Resemble That of Biological Men: An Eye-Tracking Study

Directory of Open Access Journals (Sweden)

Akira Tsujimura

2017-09-01

Tsujimura A, Kiuchi H, Soda T, et al. The Pattern of Sexual Interest of Female-to-Male Transsexual Persons With Gender Identity Disorder Does Not Resemble That of Biological Men: An Eye-Tracking Study. Sex Med 2017;5:e169–e174.

Predicting Attention-Deficit/Hyperactivity Disorder and Oppositional Defiant Disorder from Preschool Diagnostic Assessments

Science.gov (United States)

Harvey, Elizabeth A.; Youngwirth, Sara D.; Thakar, Dhara A.; Errazuriz, Paula A.

2009-01-01

The present study examined the power of measures of early preschool behavior to predict later diagnoses of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD)/conduct disorder (CD). Participants were 168 children with behavior problems at age 3 who underwent a multimethod assessment of ADHD and ODD symptoms and…

Differences in personality traits between male-to-female and female-to-male gender identity disorder subjects.

Science.gov (United States)

Miyajima, Eiichi; Taira, Naoki; Koda, Munenaga; Kondo, Tsuyoshi

2014-12-15

The present study aimed to investigate differences in personality traits among male-to-female (MtF), female-to-male (FtM) gender identity disorder (GID) subjects and non-transsexual male (M) and female (F) controls. Subjects were 72 MtF and 187 FtM GID subjects without psychiatric comorbidities together with 184 male and 159 female non-transsexual controls. Personality traits were assessed using a short version of the Temperament and Character Inventory (TCI-125). Group comparisons were made by two-way ANOVA. Statistical significances were observed as follows: 1) lower novelty seeking in FtM than in M or MtF, 2) higher reward dependence in FtM than in M, 3) higher cooperativeness in FtM than in M or MtF, 4) the highest self-transcendence in MtF among all the groups. The highest self-transcendence in MtF subjects may reflect their vulnerable identity and constrained adaptation to society as the minority. Nevertheless, higher reward dependence and cooperativeness in FtM subjects can be related to more determined motivation for the treatments of GID and might promise better social functioning and adjustment than MtF subjects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Gender dysphoria in pervasive developmental disorders].

Science.gov (United States)

Tateno, Masaru; Ikeda, Hiroshi; Saito, Toshikazu

2011-01-01

Pervasive developmental disorders (PDD) are characterized by two essential symptoms: impairment in social interaction, and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. PDD include autistic disorder, Asperger's disorder, and PDD-Not Otherwise Specified (PDD-NOS). These three disorders are sometimes termed autism spectrum disorders. A recent epidemiological survey demonstrated that the rate of PDD may be almost 1% and that many PDD cases might not be diagnosed properly in childhood. Erik Erikson described eight stages of psychosocial development through which a normally developing human should pass from infancy to adulthood. In the theory, an adolescent shows 'Identity vs. Role Confusion'. It has been reported that individuals with PDD often have identity crises which sometimes include gender dysphoria. This phenomenon might be related to the so-called identity diffusion in youth. When they reach their young youth, it has been said that subjects with PDD realize their uniqueness and differences compared to others, and, as a result, they may develop confusion of identity which could be exhibited as gender identity disorder. A recent study demonstrated that, amongst 204 children and adolescents who visited a GID clinic in the Netherlands, 7.8% were diagnosed with autism spectrum disorders after a careful diagnostic procedure by a multi-disciplinary team. Taken together, PDD and GID seem closely related to each other. In this paper, we present four PDD cases with gender dysphoria and related symptoms: 1) a girl with PDD who repeatedly asserted gender identity disorder (GID) symptoms in response to social isolation at school, 2) a junior high school boy with PDD and transvestism, 3) a boy diagnosed with Asperger's disorder who developed a disturbance of sexual orientation, and 4) a boy with Asperger's disorder and comorbid childhood GID. Many of the clinical symptoms related to gender dysphoria might be explained by the

Long-Term Follow-Up of Adults with Gender Identity Disorder.

Science.gov (United States)

Ruppin, Ulrike; Pfäfflin, Friedemann

2015-07-01

The aim of this study was to re-examine individuals with gender identity disorder after as long a period of time as possible. To meet the inclusion criterion, the legal recognition of participants' gender change via a legal name change had to date back at least 10 years. The sample comprised 71 participants (35 MtF and 36 FtM). The follow-up period was 10-24 years with a mean of 13.8 years (SD = 2.78). Instruments included a combination of qualitative and quantitative methods: Clinical interviews were conducted with the participants, and they completed a follow-up questionnaire as well as several standardized questionnaires they had already filled in when they first made contact with the clinic. Positive and desired changes were determined by all of the instruments: Participants reported high degrees of well-being and a good social integration. Very few participants were unemployed, most of them had a steady relationship, and they were also satisfied with their relationships with family and friends. Their overall evaluation of the treatment process for sex reassignment and its effectiveness in reducing gender dysphoria was positive. Regarding the results of the standardized questionnaires, participants showed significantly fewer psychological problems and interpersonal difficulties as well as a strongly increased life satisfaction at follow-up than at the time of the initial consultation. Despite these positive results, the treatment of transsexualism is far from being perfect.

Lack of leadership confidence relates to problem drinking in women: gender identity, heavy episodic drinking and alcohol use disorders in Swedish women.

Science.gov (United States)

Hensing, Gunnel; Spak, Fredrik

2009-01-01

The aim of this study was to analyse in women the association between four dimensions of gender identity, heavy episodic drinking (HED) and alcohol use disorders (AUD), taking into account age, personality, psychiatric co-morbidity and level of education. An initial screening of alcohol consumption was followed by a structured psychiatric interview in a sample of women drawn from the Gothenburg population and women attending primary care, maternity and hospital services (n = 930). Gender identity was assessed using the Masculinity-Femininity Questionnaire (M/F-Q) (items grouped into four dimensions: leadership, caring, self-assertiveness and emotionality). The Karolinska Scale of Personality was administered. Clinical psychiatric diagnoses according to DSM were made in face-to-face interviews. HED was defined as consumption of at least 60 g of ethanol on a single day at least once a month. Women who scored low on the leadership dimension were twice as likely to have AUD [age-adjusted odds1.98 (95% confidence interval 1.30-3.01)] compared to those with medium scores. These odds ratios were significant after adjustment for personality [2.21 (1.35-3.63)], psychiatric disorders [2.09 (1.25-3.47)] and level of education [1.95 (1.17-3.26)]. Low scores on the leadership dimension were associated with HED [1.55 (0.98-2.44)] after adjustment for age, personality, psychiatric disorders and level of education. High scores on leadership were not significantly associated with AUD or HED after these adjustments. The odds ratios for those who scored low on caring were non-significant throughout the analyses of associations with both AUD and HED. A similar pattern was found for the self-assertiveness dimension. Low emotionality was associated with decreased odds for AUD [0.42 (0.25-0.70)] and HED [0.66 (0.44-0.99)], and increased odds for AUD [2.14 (1.38-3.31)] and HED [2.33 (1.58-3.44)], after adjusting for age. These associations became non-significant after adjustment for

Body integrity identity disorder: deranged body processing, right fronto-parietal dysfunction, and phenomenological experience of body incongruity.

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Giummarra, Melita J; Bradshaw, John L; Nicholls, Michael E R; Hilti, Leonie M; Brugger, Peter

2011-12-01

Body integrity identity disorder (BIID) is characterised by profound experience of incongruity between the biological and desired body structure. The condition manifests in "non-belonging" of body parts, and the subsequent desire to amputate, paralyse or disable a limb. Little is known about BIID; however, a neuropsychological model implicating right fronto-parietal and insular networks is emerging, with potential disruption to body representation. We argue that, as there is scant systematic research on BIID published to date and much of the research is methodologically weak, it is premature to assume that the only process underlying bodily experience that is compromised is body representation. The present review systematically investigates which aspects of neurological processing of the body, and sense of self, may be compromised in BIID. We argue that the disorder most likely reflects dysregulation in multiple levels of body processing. That is, the disunity between self and the body could arguably come about through congenital and/or developmental disruption of body representations, which, together with altered multisensory integration, may preclude the experience of self-attribution and embodiment of affected body parts. Ulimately, there is a need for official diagnostic criteria to facilitate epidemiological characterisation of BIID, and for further research to systematically investigate which aspects of body representation and processing are truly compromised in the disorder.

Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States

NARCIS (Netherlands)

Reinders, A. A. T. Simone; Willemsen, Antoon T. M.; Vos, Herry P. J.; den Boer, Johan A.; Nijenhuis, Ellert R. S.

2012-01-01

Background: Dissociative identity disorder (DID) is a disputed psychiatric disorder. Research findings and clinical observations suggest that DID involves an authentic mental disorder related to factors such as traumatization and disrupted attachment. A competing view indicates that DID is due to

Discrimination, Racial/Ethnic Identity, and Substance Use Among Latina/os: Are They Gendered?

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Jackson, Benita; Rivera-Olmedo, Noemi

2016-01-01

Background Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os. Purpose The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables. Methods We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder. Results Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome. Conclusions Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity. PMID:26489844

Type 3 Thyroplasty for a Patient with Female-to-Male Gender Identity Disorder.

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Saito, Yu; Nakamura, Kazuhiro; Itani, Shigeto; Tsukahara, Kiyoaki

2018-01-01

In most cases, about the voice of the patient with female-to-male/gender identity disorder (FTM/GID), hormone therapy makes the voice low-pitched. In success cases, there is no need for phonosurgery. However, hormone therapy is not effective in some cases. We perform type 3 thyroplasty in these cases. Hormone therapy was started in 2008 but did not lower the speaking fundamental frequencies (SFFs). We therefore performed TP3 under local anesthesia. In our case, the SFF at the first visit was 146 Hz. The postoperative SFF was 110 Hz. TP3 was performed under local anesthesia in a patient with FTM/GID in whom hormone therapy proved ineffective. With successful conversion to a lower-pitched voice, the patient could begin to live daily life as a male. QOL improved significantly with TP3. If hormone therapy proves ineffective, TP3 may be selected as an optional treatment and appears to show few surgical complications and was, in this case, a very effective treatment.

Type 3 Thyroplasty for a Patient with Female-to-Male Gender Identity Disorder

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Yu Saito

2018-01-01

Full Text Available Objective. In most cases, about the voice of the patient with female-to-male/gender identity disorder (FTM/GID, hormone therapy makes the voice low-pitched. In success cases, there is no need for phonosurgery. However, hormone therapy is not effective in some cases. We perform type 3 thyroplasty in these cases. Method. Hormone therapy was started in 2008 but did not lower the speaking fundamental frequencies (SFFs. We therefore performed TP3 under local anesthesia. Results. In our case, the SFF at the first visit was 146 Hz. The postoperative SFF was 110 Hz. Conclusions. TP3 was performed under local anesthesia in a patient with FTM/GID in whom hormone therapy proved ineffective. With successful conversion to a lower-pitched voice, the patient could begin to live daily life as a male. QOL improved significantly with TP3. If hormone therapy proves ineffective, TP3 may be selected as an optional treatment and appears to show few surgical complications and was, in this case, a very effective treatment.

Illness Identity in Adults with a Chronic Illness.

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Oris, Leen; Luyckx, Koen; Rassart, Jessica; Goubert, Liesbet; Goossens, Eva; Apers, Silke; Arat, Seher; Vandenberghe, Joris; Westhovens, René; Moons, Philip

2018-02-21

The present study examines the concept of illness identity, the degree to which a chronic illness is integrated into one's identity, in adults with a chronic illness by validating a new self-report questionnaire, the Illness Identity Questionnaire (IIQ). Self-report questionnaires on illness identity, psychological, and physical functioning were assessed in two samples: adults with congenital heart disease (22-78 year old; n = 276) and with multisystem connective tissue disorders (systemic lupus erythematosus or systemic sclerosis; 17-81 year old; n = 241). The IIQ could differentiate four illness identity states (i.e., engulfment, rejection, acceptance, and enrichment) in both samples, based on exploratory and confirmatory factor analysis. All four subscales proved to be reliable. Rejection and engulfment were related to maladaptive psychological and physical functioning, whereas acceptance and enrichment were related to adaptive psychological and physical functioning. The present findings underscore the importance of the concept of illness identity. The IIQ, a self-report questionnaire, is introduced to measure four different illness identity states in adults with a chronic illness.

Fact or factitious? A psychobiological study of authentic and simulated dissociative identity states.

Science.gov (United States)

Reinders, A A T S; Reinders, A A T Simone; Willemsen, Antoon T M; Vos, Herry P J; den Boer, Johan A; Nijenhuis, Ellert R S

2012-01-01

Dissociative identity disorder (DID) is a disputed psychiatric disorder. Research findings and clinical observations suggest that DID involves an authentic mental disorder related to factors such as traumatization and disrupted attachment. A competing view indicates that DID is due to fantasy proneness, suggestibility, suggestion, and role-playing. Here we examine whether dissociative identity state-dependent psychobiological features in DID can be induced in high or low fantasy prone individuals by instructed and motivated role-playing, and suggestion. DID patients, high fantasy prone and low fantasy prone controls were studied in two different types of identity states (neutral and trauma-related) in an autobiographical memory script-driven (neutral or trauma-related) imagery paradigm. The controls were instructed to enact the two DID identity states. Twenty-nine subjects participated in the study: 11 patients with DID, 10 high fantasy prone DID simulating controls, and 8 low fantasy prone DID simulating controls. Autonomic and subjective reactions were obtained. Differences in psychophysiological and neural activation patterns were found between the DID patients and both high and low fantasy prone controls. That is, the identity states in DID were not convincingly enacted by DID simulating controls. Thus, important differences regarding regional cerebral bloodflow and psychophysiological responses for different types of identity states in patients with DID were upheld after controlling for DID simulation. 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.

The importance of identity and empowerment to teenagers with developmental co-ordination disorder.

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Lingam, R P; Novak, C; Emond, A; Coad, J E

2014-05-01

The aim of the current study was to gain an understanding of the experiences and aspirations of young people living with Developmental Coordination Disorder (DCD) in their own words. Eleven young people aged 11-16 years with a prior diagnosis of DCD were identified from child health records of two participating NHS trusts. The sample included seven boys and four girls, from different socio-economic backgrounds living in different parts of one large urban area in England. In depth one-to-one semi-structured interviews and subsequent follow-up small group interviews were carried out with the young people. Interviews were enhanced using participatory arts-based techniques. All interviews were recorded verbatim and transcribed. Narrative data were analysed using Lindseth's interpretive phenomenology. The central theme of 'We're all different' described how the young person saw themselves and encompassed the formation of identity. Subthemes illustrated the attitude of the young people to their day to day lives, their difficulties and strategies used by the young people to overcome these difficulties in school and at home. The attitude of the school to difference, the presence of bullying, the accepting nature of the class, teachers and peers were vitally important. Areas of life that encouraged a positive sense of identity and worth included being part of a social network that gave the young people a sense of belonging, potentially one that valued differences as well as similarities. The current work highlights the need for services to adopt a model of DCD where the young person talks about what they can do and considers strategies of overcoming their difficulties. This has implications for education and future intervention strategies that focus on fostering psychological resilience and educational coping strategies rather than simply attempting to improve motor skills. © 2013 John Wiley & Sons Ltd.

Biracial Japanese American identity: an evolving process.

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Collins, J F

2000-05-01

This qualitative study explored the complexity of biracial identity development in Japanese Americans. It is based on the constant comparable method of analysis, or grounded theory. The study focused on how Japanese Americans perceived themselves in relation to other individuals, groups, and their environment. The data consisted of 15 extensive semistructured interviews with 8 men and 7 women (ages 20 to 40 years), each with 1 Japanese parent and 1 non-Asian parent. Findings relate to participants' initiating explorations of identity and perseverance in pursuing a biracial identity, which depended on the degree of support or negative experience within their social networks. Participants explored identity options attempting to develop their own meaning of identity, to develop a confident sense of themselves, and to secure a positive ethnic identity. Identity development among participants varied. It was a long-term process involving changes in the individual-environment relationship, which differed in the way individual participants influenced or selected from environmental opportunities, even creating or recreating some aspects. Within a given setting, as youths, the potential for social experiences were relatively fixed and changed only gradually. As adults, there were opportunities for participants to select their own social and geographic settings, providing opportunity for change. In their new environments, participants were exposed to new contacts and role models, acquired new behavioral repertoire, and underwent role transitions. Depending on this, new and different aspects of biracial identity developed. Participants indicated it was an emotional and conflictual process to positive assertion of identity. Before reaching this, all of the participants experienced periods of confusion. Most asserted biracial identity gradually, through a process of racial identity development consisting of the individual's changing or maintaining certain reference group

[Clinical Handling of Patients with Dissociative Disorders].

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Okano, Kenichiro

2015-01-01

This paper discusses the way informed psychiatrists are expected to handle dissociative patients in clinical situations, with a specific focus on dissociative identity disorders and dissociative fugue. On the initial interview with dissociative patients, information on their history of trauma and any nascent dissociative symptoms in their childhood should be carefully obtained. Their level of stress in their current life should also be assessed in order to understand their symptomatology, as well as to predict their future clinical course. A psychoeducational approach is crucial; it might be helpful to give information on dissociative disorder to these patients as well as their family members in order to promote their adherence to treatment. Regarding the symptomatology of dissociative disorders, detailed symptoms and the general clinical course are presented. It was stressed that dissociative identity disorder and dissociative fugue, the most high-profile dissociative disorders, are essentially different in their etiology and clinical presentation. Dissociative disorders are often confused with and misdiagnosed as psychotic disorders, such as schizophrenia. Other conditions considered in terms of the differential diagnosis include borderline personality disorder as well as temporal lobe epilepsy. Lastly, the therapeutic approach to dissociative identity disorder is discussed. Each dissociative identity should be understood as potentially representing some traumatically stressful event in the past. The therapist should be careful not to excessively promote the creation or elaboration of any dissociative identities. Three stages are proposed in the individual psychotherapeutic process. In the initial stage, a secure environment and stabilization of symptoms should be sought. The second stage consists of aiding the "host" personality to make use of other more adaptive coping skills in their life. The third stage involves coaching as well as continuous awareness of

Chronic complex dissociative disorders and borderline personality disorder: disorders of emotion dysregulation?

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Brand, Bethany L; Lanius, Ruth A

2014-01-01

Emotion dysregulation is a core feature of chronic complex dissociative disorders (DD), as it is for borderline personality disorder (BPD). Chronic complex DD include dissociative identity disorder (DID) and the most common form of dissociative disorder not otherwise specified (DDNOS, type 1), now known as Other Specified Dissociative Disorders (OSDD, type 1). BPD is a common comorbid disorder with DD, although preliminary research indicates the disorders have some distinguishing features as well as considerable overlap. This article focuses on the epidemiology, clinical presentation, psychological profile, treatment, and neurobiology of chronic complex DD with emphasis placed on the role of emotion dysregulation in each of these areas. Trauma experts conceptualize borderline symptoms as often being trauma based, as are chronic complex DD. We review the preliminary research that compares DD to BPD in the hopes that this will stimulate additional comparative research.

Sliding Doors: should treatment of gender identity disorder and other body modifications be privately funded?

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Giordano, Simona

2012-02-01

Gender Identity Disorder (GID) is regarded as a mental illness and included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It will also appear in the DSM-V, due to be published in 2013. The classification of GID as a mental illness is contentious. But what would happen to sufferers if it were removed from the diagnostic manuals? Would people lose their entitlement to funded medical care, or to reimbursement under insurance schemes? On what basis should medical treatment for GID be provided? What are the moral arguments for and against funded or reimbursed medical care for GID? This paper starts out with a fiction: GID is removed from the diagnostic manuals. Then the paper splits in two, as in happened in the Howitt's 1998 film Sliding Doors. The two scenarios run parallel. In one, it is argued that GID is on a par with other body modifications, such as cosmetic and racial surgery, and that, for ethical reasons, treatment for GID should be privately negotiated by applicants and professionals and privately paid for. In the other scenario, it is argued that the comparison between GID and other body modifications is misleading. Whether or not medical treatment should be funded or reimbursed is independent of whether GID is on a par with other forms of body dissatisfaction.

Eating Disorders in Obsessive-Compulsive Disorder: Prevalence and Effect on Treatment Outcome

OpenAIRE

Tobiassen, Linn Graham

2013-01-01

The aim of the present study was to examine the prevalence of eating disorder symptoms in patients with obsessive-compulsive disorder (OCD). Additional aims were to assess whether having comorbid eating disorders could influence the treatment outcome for OCD, and if symptoms of eating disorders were reduced after treatment for OCD. The sample consisted of 93 patients with a primary diagnosis of OCD. The patients underwent assessment with the Yale-Brown Obsessive-Compulsive Scale, Beck Depress...

Attachment Styles in Sufferers of Gender Identity Disorder in Fars Province in 2014

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Mahmoodi

2016-02-01

Full Text Available Background Gender identity disorder (GID is considered as a very complicated clinical case and there are usually various variables in the inside-family-communication atmosphere. Objectives The aim of this study was to determine attachment styles in people with GID and compare them with normal people in Fars province, Iran. Materials and Methods This case-control study with accessible sampling was conducted in Fars province, Iran, in 2014 using 60 visitors to the Fars province forensics head office who had been diagnosed as having GID by the commission of psychology (the case group and 204 individuals in dispose, whom psychologists diagnosed as having no psychological disorder and in synchronization with the sample group (controls. The demographic questionnaire and Collins and Read attachment style questionnaires were used in both groups. Data were collected and then analyzed using the SPSS software version 18, Kormogrov Smirnov’s normality test and Pearson’s correlation coefficient. A significance level of P < 0.05 was considered significant. Results Findings showed that the highest frequency (71% in terms of secure attachment and the lowest frequency (0% in terms of avoidant attachment were observed in patients with GID who had been operated and the highest frequency of avoidant attachment (62.1% and the lowest frequency of secure attachment (0% were observed in patients with GID who had not been operated. Conclusions According to the findings of this study, GID patients who have been operated are more secure in attachment styles than those who have not been operated, and there is a significant correlation between age, education and gender with attachment style among these individuals.

Neurodevelopmental origins of abnormal cortical morphology in dissociative identity disorder.

Science.gov (United States)

Reinders, A A T S; Chalavi, S; Schlumpf, Y R; Vissia, E M; Nijenhuis, E R S; Jäncke, L; Veltman, D J; Ecker, C

2018-02-01

To examine the two constitutes of cortical volume (CV), that is, cortical thickness (CT) and surface area (SA), in individuals with dissociative identity disorder (DID) with the view of gaining important novel insights into the underlying neurobiological mechanisms mediating DID. This study included 32 female patients with DID and 43 matched healthy controls. Between-group differences in CV, thickness, and SA, the degree of spatial overlap between differences in CT and SA, and their relative contribution to differences in regional CV were assessed using a novel spatially unbiased vertex-wise approach. Whole-brain correlation analyses were performed between measures of cortical anatomy and dissociative symptoms and traumatization. Individuals with DID differed from controls in CV, CT, and SA, with significantly decreased CT in the insula, anterior cingulate, and parietal regions and reduced cortical SA in temporal and orbitofrontal cortices. Abnormalities in CT and SA shared only about 3% of all significantly different cerebral surface locations and involved distinct contributions to the abnormality of CV in DID. Significant negative associations between abnormal brain morphology (SA and CV) and dissociative symptoms and early childhood traumatization (0 and 3 years of age) were found. In DID, neuroanatomical areas with decreased CT and SA are in different locations in the brain. As CT and SA have distinct genetic and developmental origins, our findings may indicate that different neurobiological mechanisms and environmental factors impact on cortical morphology in DID, such as early childhood traumatization. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Neural basis of limb ownership in individuals with body integrity identity disorder.

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Milenna T van Dijk

Full Text Available Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs that do and do not feel as part of the body using functional MRI during separate tactile stimulation and motor execution experiments. In comparison to matched controls, individuals with BIID showed heightened responsivity of a large somatosensory network including the parietal cortex and right insula during tactile stimulation, regardless of whether the stimulated leg felt owned or alienated. Importantly, activity in the ventral premotor cortex depended on the feeling of ownership and was reduced during stimulation of the alienated compared to the owned leg. In contrast, no significant differences between groups were observed during the performance of motor actions. These results suggest that altered somatosensory processing in the premotor cortex is associated with the feeling of disownership in BIID, which may be related to altered integration of somatosensory and proprioceptive information.

Body integrity identity disorder: the persistent desire to acquire a physical disability.

Science.gov (United States)

First, Michael B; Fisher, Carl E

2012-01-01

Body integrity identity disorder (BIID) is a rare and unusual psychiatric condition characterized by a persistent desire to acquire a physical disability (e.g., amputation, paraplegia) since childhood that to date has not been formally described in the psychiatric nosology. Most BIID sufferers experience a chronic and dysphoric sense of inappropriateness regarding their being able-bodied, and many have been driven to actualize their desired disability through surreptitious surgical or other more dangerous methods. This review aims to characterize the history and phenomenology of this condition, to present its differential diagnosis, and to consider possible etiologies, treatment options, and ethical considerations. Review of the psychiatric and neurological literature. A growing body of data suggests the existence of a discrete entity with onset by early adolescence and a negative impact on functioning. Parallel neurological conditions and preliminary experimental investigations suggest a possible neurobiological component in at least a portion of cases. While attempts at treatment have been described, no systematic evidence for efficacy has emerged. BIID is a unique nosological entity with significant consequences for its sufferers and as such may warrant inclusion in some form in the forthcoming DSM-5 and ICD-11. Copyright © 2011 S. Karger AG, Basel.

Neural basis of limb ownership in individuals with body integrity identity disorder.

Science.gov (United States)

van Dijk, Milenna T; van Wingen, Guido A; van Lammeren, Anouk; Blom, Rianne M; de Kwaasteniet, Bart P; Scholte, H Steven; Denys, Damiaan

2013-01-01

Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs that do and do not feel as part of the body using functional MRI during separate tactile stimulation and motor execution experiments. In comparison to matched controls, individuals with BIID showed heightened responsivity of a large somatosensory network including the parietal cortex and right insula during tactile stimulation, regardless of whether the stimulated leg felt owned or alienated. Importantly, activity in the ventral premotor cortex depended on the feeling of ownership and was reduced during stimulation of the alienated compared to the owned leg. In contrast, no significant differences between groups were observed during the performance of motor actions. These results suggest that altered somatosensory processing in the premotor cortex is associated with the feeling of disownership in BIID, which may be related to altered integration of somatosensory and proprioceptive information.

[Psychological features of body integrity identity disorder (BIID): personality traits, interpersonal aspects, coping mechanisms regarding stress and conflicts, body perception].

Science.gov (United States)

Oddo, S; Möller, J; Skoruppa, S; Stirn, A

2014-05-01

In BIID a disorder of body identity, concerned subjects desire an amputation of a healthy limb. So far, no psychiatric comorbidity was found in the few studies on BIID-subjects. This study explored clinical symptoms, personality characteristics, interpersonal aspects and coping strategies in 15 BIID persons. Psychometric testing on the topics (1) clinical symptoms, (2) personality and interpersonal aspects, (3) coping strategies, (4) attitudes towards the body were used and statistically evaluated with the T-test for one sample. Some psychopathologies such as depression, anxiety and obsessive-compulsive disorders (OCD) could be excluded although an increased tendency of depressiveness was found. BIID subjects showed specific personality and interpersonal characteristics: high agreeableness, autonomy, autarky and restrained behaviour towards others. Stress and conflicts are managed by self-control and self-affirmation. Their subjective physical attractiveness was low. BIID persons do not exhibit psychopathological characteristics (such as anxiety, depression or OCD), but do show specifics in personality, relationships and coping mechanisms. In the future, further personality traits and personality disorders should be investigated to shed more light on the categorisation and treatment of BIID. © Georg Thieme Verlag KG Stuttgart · New York.

Fact or factitious? A psychobiological study of authentic and simulated dissociative identity states.

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A A T S Reinders

Full Text Available BACKGROUND: Dissociative identity disorder (DID is a disputed psychiatric disorder. Research findings and clinical observations suggest that DID involves an authentic mental disorder related to factors such as traumatization and disrupted attachment. A competing view indicates that DID is due to fantasy proneness, suggestibility, suggestion, and role-playing. Here we examine whether dissociative identity state-dependent psychobiological features in DID can be induced in high or low fantasy prone individuals by instructed and motivated role-playing, and suggestion. METHODOLOGY/PRINCIPAL FINDINGS: DID patients, high fantasy prone and low fantasy prone controls were studied in two different types of identity states (neutral and trauma-related in an autobiographical memory script-driven (neutral or trauma-related imagery paradigm. The controls were instructed to enact the two DID identity states. Twenty-nine subjects participated in the study: 11 patients with DID, 10 high fantasy prone DID simulating controls, and 8 low fantasy prone DID simulating controls. Autonomic and subjective reactions were obtained. Differences in psychophysiological and neural activation patterns were found between the DID patients and both high and low fantasy prone controls. That is, the identity states in DID were not convincingly enacted by DID simulating controls. Thus, important differences regarding regional cerebral bloodflow and psychophysiological responses for different types of identity states in patients with DID were upheld after controlling for DID simulation. CONCLUSIONS/SIGNIFICANCE: 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.

Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States

Science.gov (United States)

Simone Reinders, A. A. T.; Willemsen, Antoon T. M.; Vos, Herry P. J.; den Boer, Johan A.; Nijenhuis, Ellert R. S.

2012-01-01

Background Dissociative identity disorder (DID) is a disputed psychiatric disorder. Research findings and clinical observations suggest that DID involves an authentic mental disorder related to factors such as traumatization and disrupted attachment. A competing view indicates that DID is due to fantasy proneness, suggestibility, suggestion, and role-playing. Here we examine whether dissociative identity state-dependent psychobiological features in DID can be induced in high or low fantasy prone individuals by instructed and motivated role-playing, and suggestion. Methodology/Principal Findings DID patients, high fantasy prone and low fantasy prone controls were studied in two different types of identity states (neutral and trauma-related) in an autobiographical memory script-driven (neutral or trauma-related) imagery paradigm. The controls were instructed to enact the two DID identity states. Twenty-nine subjects participated in the study: 11 patients with DID, 10 high fantasy prone DID simulating controls, and 8 low fantasy prone DID simulating controls. Autonomic and subjective reactions were obtained. Differences in psychophysiological and neural activation patterns were found between the DID patients and both high and low fantasy prone controls. That is, the identity states in DID were not convincingly enacted by DID simulating controls. Thus, important differences regarding regional cerebral bloodflow and psychophysiological responses for different types of identity states in patients with DID were upheld after controlling for DID simulation. Conclusions/Significance 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. PMID:22768068

Identity's identities

DEFF Research Database (Denmark)

Jensen, Kim Ebensgaard

-specialized language in which it also serves a number of functions – some of which are quite fundamental to society as such. In other words, the lexeme identity is a polysemic word and has multiple, well, identities. Given that it appears to have a number of functions in a variety of registers, including terminologies...... in Academic English and more everyday-based English, identity as a lexeme is definitely worth having a look at. This paper presents a lexicological study of identity in which some of its senses are identified and their behaviors in actual discourse are observed. Drawing on data from the 2011 section...... of the Corpus of Contemporary American English, a behavioral profile of the distributional characteristics of identity is set up. Behavioral profiling is a lexicographical method developed by the corpus linguist Stefan Th. Gries which, by applying semantic ID tagging and statistical analysis, provides a fine...

Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents

NARCIS (Netherlands)

de Vries, A.L.C.; Noens, I.L.J.; Cohen-Kettenis, P.T.; Berckelaer-Onnes, I.A.; Doreleijers, T.A.H.

2010-01-01

Only case reports have described the co-occurrence of gender identity disorder (GID) and autism spectrum disorders (ASD). This study examined this co-occurrence using a systematic approach. Children and adolescents (115 boys and 89 girls, mean age 10.8, SD = 3.58) referred to a gender identity

Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder.

Science.gov (United States)

Byne, William; Bradley, Susan J; Coleman, Eli; Eyler, A Evan; Green, Richard; Menvielle, Edgardo J; Meyer-Bahlburg, Heino F L; Pleak, Richard R; Tompkins, D Andrew

2012-08-01

Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA. The literature on treatment of gender dysphoria in individuals with disorders of sex development was also assessed. The completed report was accepted by the BOT on September 11, 2011. The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups. With subjective improvement as the primary outcome measure, current evidence was judged sufficient to support recommendations for adults in the form of an evidence-based APA Practice Guideline with gaps in the empirical data supplemented by clinical consensus. The report recommends that the APA take steps beyond drafting treatment recommendations. These include issuing position statements to clarify the APA's position regarding the medical necessity of treatments for GID, the ethical bounds of treatments of gender variant minors, and the rights of persons of any age who are gender variant, transgender or transsexual.

[Tacit metarepresentation and affective sense of personal identity. An approach to understanding severe psychiatric disorders of adolescence and young adulthood].

Science.gov (United States)

Balbi, Juan

2011-01-01

The results of present-day research in the field of "Dissociation Paradigm", regarding the capacity of the human mind to perceive, learn, and store information that in appearance passes as unnoticed, support the constructivist hypothesis of the active, selective and constructive condition of consciousness, in addition to the existence of a tacit dimension of knowledge that operates in functional relationship with the former. Unconscious mental states are intrinsically intentional. This is to say that they imply a semantic or cognitive connotation that is capable of affecting phenomenical experience and therefore behavior. In addition, the precocious existence of a tacit metarepresentational system in normally developed children has been proven, which is essential for guaranteeing the deployment of the process of functional coevolution between affectivity and consciousness, by which the experience of personal identity is acquired. These discoveries allow the inference of a "tacit affective metarepresentational recurrence", the organizational foundation on which a unified, sustainable, and continuous sense of the experience of personal identity is structured, and also allow us to hypothesize a "tacit metarepresentational mourning", a specific type of grief which is the chief foundation of the majority of psychopathological disorders. This concept may represent a potential explanation of the severe mental disorders of adolescence and young adulthood. The hypothesis of the present work is that, in the ambiguous context of Postmodern Culture, the prolongation of the adolescent period, facilitated by the welfare state, hinders the dealing with the aforementioned mourning, leading to an increment of depressive states and suicidal behavior among young people.

日本性别认同障碍的发展现状综述%Review of the status and development of gender identity disorder in Japan

Institute of Scientific and Technical Information of China (English)

周宇; 李毅; 中塚幹也

2017-01-01

性别认同障碍(gender identity disorder,GID),指对于自己的性别认同与生物解剖学上的性别不一致的情况,并且常伴随内心痛苦想要改变生物学上的性别,心理治疗对性别认同障碍的干预,即想要使患者的性别认同与生物性别一致的情况早已被证实无效,性别认同障碍的患者往往会选择荷尔蒙治疗甚至手术来使自己的生物性别与性别认同趋向一致.2013年5月美国《精神疾病诊断及统计手册》第五版(DSM-Ⅴ)将性别认同障碍修改为性别烦恼(gender dysphoria),不再认为性别认同问题是障碍或疾病,承认性别多样性的存在.本文从对日本性别认同障碍患者的一般调查研究数据,包括荷尔蒙疗法及性别转变手术在内的性别认同障碍的治疗以及生殖医疗三个方面来描述日本性别认同障碍目前的发展状况.%Gender Identity Disorder (GID) refers to the inconformity between gender identity and biological gender.Individuals with GID typically suffer from the inconformity and wants to change their biological gender.It is found useless to provide psychotherapy for such individuals which tries to unify their psychological and biological gender identity.Most choose to change their biological gender through feminize or masculinize therapy or even operation.The Diagnostic and Statistical Manual of Mental Disorders (DSM-Ⅴ) published in 2013 changed gender dysphoria to gender dysphoria and admitted the diversity of gender identity.This article introduces the status and development of GID in Japan from three perspectives i.e.hormone therapy,sex reassignment surgery,and reproductive health.

Adolescents with personality disorders suffer from severe psychiatric stigma: evidence from a sample of 131 patients

Directory of Open Access Journals (Sweden)

Catthoor K

2015-05-01

Full Text Available Kirsten Catthoor,1,3 Dine J Feenstra,2 Joost Hutsebaut,2 Didier Schrijvers,3 Bernard Sabbe3 1Department of Psychiatry, Psychiatrisch Ziekenhuis Stuivenberg, ZNA Antwerpen, Antwerp, Belgium; 2Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands; 3Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Wilrijk, Belgium Background: The aim of the study is to assess the severity of psychiatric stigma in a sample of personality disordered adolescents in order to evaluate whether differences in stigma can be found in adolescents with different types and severity of personality disorders (PDs. Not only adults but children and adolescents with mental health problems suffer from psychiatric stigma. In contrast to the abundance of research in adult psychiatric samples, stigma in children and adolescents has hardly been investigated. Personality disordered adolescents with fragile identities and self-esteem might be especially prone to feeling stigmatized, an experience which might further shape their identity throughout this critical developmental phase. Materials and methods: One hundred thirty-one adolescent patients underwent a standard assessment with Axis I and Axis II diagnostic interviews and two stigma instruments, Stigma Consciousness Questionnaire (SCQ and Perceived Devaluation–Discrimination Questionnaire (PDDQ. Independent sample t-tests were used to investigate differences in the mean SCQ and PDDQ total scores for patients with and without a PD. Multiple regression main effect analyses were conducted to explore the impact of the different PDs on level of stigma, as well as comorbid Axis I disorders. Age and sex were also entered in the regression models. Results and conclusions: Adolescents with severe mental health problems experience a burden of stigma. Personality disordered patients experience more stigma than adolescents with other severe psychiatric Axis I disorders. Borderline PD

Assessing the utility of diagnostic criteria: a multisite study on gender identity disorder.

Science.gov (United States)

Paap, Muirne C S; Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T; Richter-Appelt, Hertha; de Cuypere, Griet; Haraldsen, Ira R

2011-01-01

Studies involving patients with gender identity disorder (GID) are inconsistent with regard to outcomes and often difficult to compare because of the vague descriptions of the diagnostic process. A multisite study is needed to scrutinize the utility and generality of different aspects of the diagnostic criteria for GID. To investigate the way in which the diagnosis-specific Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria for GID were used to reach a psychiatric diagnosis in four European countries: the Netherlands (Amsterdam), Norway (Oslo), Germany (Hamburg), and Belgium (Ghent). The main goal was to compare item (symptom) characteristics across countries. The current study included all new applicants to the four GID clinics who were seen between January 2007 and March 2009, were at least 16 years of age at their first visit, and had completed the diagnostic assessment (N = 214, mean age = 32 ± 12.2 years). Mokken scale analysis, a form of Nonparametric Item Response Theory (NIRT) was performed. Operationalization and quantification of the core criteria A and B resulted in a 23-item score sheet that was filled out by the participating clinicians after they had made a diagnosis. We found that, when ordering the 23 items according to their means for each country separately, the rank ordering was similar among the four countries for 21 of the items. Furthermore, only one scale emerged, which combined criteria A and B when all data were analyzed together. Our results indicate that patients' symptoms were interpreted in a similar fashion in all four countries. However, we did not find support for the treatment of A and B as two separate criteria. We recommend the use of NIRT in future studies, especially in studies with small sample sizes and/or with data that show a poor fit to parametric IRT models. © 2010 International Society for Sexual Medicine.

Demographic characteristics, social competence, and behavior problems in children with gender identity disorder: a cross-national, cross-clinic comparative analysis.

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Cohen-Kettenis, Peggy T; Owen, Allison; Kaijser, Vanessa G; Bradley, Susan J; Zucker, Kenneth J

2003-02-01

This study examined demographic characteristics, social competence, and behavior problems in clinic-referred children with gender identity problems in Toronto, Canada (N = 358), and Utrecht, The Netherlands (N = 130). The Toronto sample was, on average, about a year younger than the Utrecht sample at referral, had a higher percentage of boys, had a higher mean IQ, and was less likely to be living with both parents. On the Child Behavior Checklist (CBCL), both groups showed, on average, clinical range scores in both social competence and behavior problems. A CBCL-derived measure of poor peer relations showed that boys in both clinics had worse ratings than did the girls. A multiple regression analysis showed that poor peer relations were the strongest predictor of behavior problems in both samples. This study-the first cross-national, cross-clinic comparative analysis of children with gender identity disorder-found far more similarities than differences in both social competence and behavior problems. The most salient demographic difference was age at referral. Cross-national differences in factors that might influence referral patterns are discussed.

Hard Identity and Soft Identity

Directory of Open Access Journals (Sweden)

Hassan Rachik

2006-04-01

Full Text Available Often collective identities are classified depending on their contents and rarely depending on their forms. Differentiation between soft identity and hard identity is applied to diverse collective identities: religious, political, national, tribal ones, etc. This classification is made following the principal dimensions of collective identities: type of classification (univocal and exclusive or relative and contextual, the absence or presence of conflictsof loyalty, selective or totalitarian, objective or subjective conception, among others. The different characteristics analysed contribute to outlining an increasingly frequent type of identity: the authoritarian identity.

Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents

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de Vries, Annelou L. C.; Noens, Ilse L. J.; Cohen-Kettenis, Peggy T.; van Berckelaer-Onnes, Ina A.; Doreleijers, Theo A.

2010-01-01

Only case reports have described the co-occurrence of gender identity disorder (GID) and autism spectrum disorders (ASD). This study examined this co-occurrence using a systematic approach. Children and adolescents (115 boys and 89 girls, mean age 10.8, SD = 3.58) referred to a gender identity clinic received a standardized assessment during which…

Epidemiology of gender dysphoria and transgender identity.

Science.gov (United States)

Zucker, Kenneth J

2017-10-01

This review provides an update on the epidemiology of gender dysphoria and transgender identity in children, adolescents and adults. Although the prevalence of gender dysphoria, as it is operationalised in the fifth edtion of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), remains a relatively 'rare' or 'uncommon' diagnosis, there is evidence that it has increased in the past couple of decades, perhaps reflected in the large increase in referral rates to specialised gender identity clinics. In childhood, the sex ratio continues to favour birth-assigned males, but in adolescents, there has been a recent inversion in the sex ratio from one favouring birth-assigned males to one favouring birth-assigned females. In both adolescents and adults, patterns of sexual orientation vary as a function of birth-assigned sex. Recent studies suggest that the prevalence of a self-reported transgender identity in children, adolescents and adults ranges from 0.5 to 1.3%, markedly higher than prevalence rates based on clinic-referred samples of adults. The stability of a self-reported transgender identity or a gender identity that departs from the traditional male-female binary among non-clinic-based populations remains unknown and requires further study.

Emotion, gender, and gender typical identity in autobiographical memory.

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Grysman, Azriel; Merrill, Natalie; Fivush, Robyn

2017-03-01

Gender differences in the emotional intensity and content of autobiographical memory (AM) are inconsistent across studies, and may be influenced as much by gender identity as by categorical gender. To explore this question, data were collected from 196 participants (age 18-40), split evenly between men and women. Participants narrated four memories, a neutral event, high point event, low point event, and self-defining memory, completed ratings of emotional intensity for each event, and completed four measures of gender typical identity. For self-reported emotional intensity, gender differences in AM were mediated by identification with stereotypical feminine gender norms. For narrative use of affect terms, both gender and gender typical identity predicted affective expression. The results confirm contextual models of gender identity (e.g., Diamond, 2012 . The desire disorder in research on sexual orientation in women: Contributions of dynamical systems theory. Archives of Sexual Behavior, 41, 73-83) and underscore the dynamic interplay between gender and gender identity in the emotional expression of autobiographical memories.

What's left feels right: Studies in obsessive-compulsive disorder (OCD) and body integrity identity disorder (BIID).

OpenAIRE

Blom, R.M.

2017-01-01

Over the last decade the nosology status of obsessive-compulsive and related disorders has been topic of debate. Whereas in DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV) obsessive-compulsive disorder (OCD) was classified as an anxiety disorder, in DSM-V it is classified as a separate entity with compulsivity as the main symptom. The first part of this thesis consists of studies that contributed to this debate, investigating the prevalence of obsessions in the general popul...

Hormone treatment of gender identity disorder in a cohort of children and adolescents.

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Hewitt, Jacqueline K; Paul, Campbell; Kasiannan, Porpavai; Grover, Sonia R; Newman, Louise K; Warne, Garry L

2012-05-21

To describe the experience of hormone treatment of gender identity disorder (GID) in children and adolescents within a specialist clinic. Cohort study by medical record review of children aged 0-17 years referred during 2003-2011 for management at the GID clinic in a tertiary paediatric referral centre - the Royal Children's Hospital, Melbourne, Victoria. Clinical characteristics of the patient population, hormone treatment provided, frequency of referrals with time. Thirty-nine children and adolescents were referred for gender dysphoria. Seventeen individuals were pubertal with persistent GID, and were considered eligible for hormone treatment. Seven patients, comprising three biological males and four biological females, had legally endorsed hormone treatment. In this group, gender dysphoria was first noted at 3-6 years of age. Hormone treatment with GnRH analogue to suppress pubertal progression (phase 1) was given at 10-16 years of age. Treatment with cross-sex hormones (phase 2) was given at 15.6-16 years. One patient purchased cross-sex hormone treatment overseas. One patient received oestrogen and progesterone for menstrual suppression before phase 1. The annual frequency of new referrals increased continuously over the study period. Hormone treatment for pubertal suppression and subsequent gender transition needs to be individualised within stringent protocols in multidisciplinary specialist units.

Dissociative Spectrum Disorders in the Primary Care Setting

OpenAIRE

Elmore, James L.

2000-01-01

Dissociative disorders have a lifetime prevalence of about 10%. Dissociative symptoms may occur in acute stress disorder, posttraumatic stress disorder, somatization disorder, substance abuse, trance and possession trance, Ganser's syndrome, and dissociative identity disorder, as well as in mood disorders, psychoses, and personality disorders. Dissociative symptoms and disorders are observed frequently among patients attending our rural South Carolina community mental health center. Given the...

What’s left feels right : Studies in obsessive-compulsive disorder (OCD) and body integrity identity disorder (BIID)

NARCIS (Netherlands)

Blom, R.M.

2017-01-01

Over the last decade the nosology status of obsessive-compulsive and related disorders has been topic of debate. Whereas in DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV) obsessive-compulsive disorder (OCD) was classified as an anxiety disorder, in DSM-V it is classified as a

Biological aspects of gender disorders.

Science.gov (United States)

Corsello, S M; Di Donna, V; Senes, P; Luotto, V; Ricciato, M P; Paragliola, R M; Pontecorvi, A

2011-12-01

The scientific community is very interested in the biological aspects of gender disorders and sexual orientation. There are different levels to define an individual's sex: chromosomal, gonadic, and phenotypic sex. Concerning the psychological sex, men and women are different by virtue of their own gender identity, which means they recognize themselves as belonging to a determinate sex. They are different also as a result of their own role identity, a set of behaviors, tendencies, and cognitive and emotional attitudes, commonly defined as "male" and "female". Transsexuality is a disorder characterized by the development of a gender identity opposed to phenotypic sex, whereas homosexuality is not a disturbance of gender identity but only of sexual attraction, expressing sexual orientation towards people of the same sex. We started from a critical review of literature on genetic and hormonal mechanisms involved in sexual differentiation. We re-examined the neuro-anatomic and functional differences between men and women, with special reference to their role in psychosexual differentiation and to their possible implication in the genesis of homosexuality and identity gender disorders. Homosexuality and transsexuality are conditions without a well defined etiology. Although the influence of educational and environmental factors in humans is undeniable, it seems that organic neurohormonal prenatal and postnatal factors might contribute in a determinant way in the development of these two conditions. This "organicistic neurohormal theory" might find support in the study of particular situations in which the human fetus is exposed to an abnormal hormonal environment in utero.

Hysterectomy and Bilateral Salpingoovariectomy in a Transsexual Subject without Visible Scaring

OpenAIRE

Perrone, Anna Myriam; Scifo, Maria Cristina; Martelli, Valentina; Casadio, Paolo; Morselli, Paolo Giovanni; Pelusi, Giuseppe; Meriggiola, Maria Cristina

2010-01-01

Objective. To report on the use of laparoendoscopic single-site surgery (LESS) for the management of total hysterectomy (TH) with bilateral salpingoovariectomy (BSO) in a subject affected by gender identity disorder. Design. Case report. Setting. University Hospital. Patient(s). A 27-year-old affected by Gender Identity Disorder underwent a hysterectomy and BSO as part of surgical sex reassignment. Intervention(s). Laparoendoscopic single-site surgery access for TH and BSO. Main Outcome ...

Current management of gender identity disorder in childhood and adolescence: guidelines, barriers and areas of controversy.

Science.gov (United States)

Shumer, Daniel E; Spack, Norman P

2013-02-01

The approach to gender identity disorder (GID) in childhood and adolescence has been rapidly evolving and is in a state of flux. In an effort to form management recommendations on the basis of the available literature, The Endocrine Society published clinical practice guidelines in 2009. The guidelines recommend against sex role change in prepubertal children, but they recommend the use of gonadotropin-releasing hormone (GnRH) agonists to suppress puberty in adolescence, and the use of cross-sex hormones starting around age 16 for eligible patients. In actual practice, the approach to GID is quite variable due to continued lack of consensus and specific barriers to treatment that are unique to GID. Recent literature has focused on the mental health approach to prepubertal children with GID and short-term outcomes using pubertal suppression and cross-sex steroids in adolescents with GID. This review will describe the literature published since the release of The Endocrine Society guidelines regarding the management of GID in both children and adolescents.

Predicting borderline personality disorder features from personality traits, identity orientation, and attachment styles in Italian nonclinical adults: issues of consistency across age ranges.

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Fossati, Andrea; Borroni, Serena; Feeney, Judith; Maffei, Cesare

2012-04-01

The aims of this study were to assess whether Borderline Personality Disorder (BPD) features could be predicted by Big Five traits, impulsivity, identity orientation, and adult attachment patterns in a sample of 1,192 adult nonclinical participants, and to evaluate the consistency of these regression models across four age groups (49 years, and >50 years, respectively). In the full sample, measures of neuroticism (N), impulsivity, and anxious insecure attachment were substantial predictors of BPD features (adjusted R(2) = .38, p personality traits and disturbed attachment patterns.

Egocentric virtual maze learning in adult survivors of childhood abuse with dissociative disorders: evidence from functional magnetic resonance imaging.

Science.gov (United States)

Weniger, Godehard; Siemerkus, Jakob; Barke, Antonia; Lange, Claudia; Ruhleder, Mirjana; Sachsse, Ulrich; Schmidt-Samoa, Carsten; Dechent, Peter; Irle, Eva

2013-05-30

Present neuroimaging findings suggest two subtypes of trauma response, one characterized predominantly by hyperarousal and intrusions, and the other primarily by dissociative symptoms. The neural underpinnings of these two subtypes need to be better defined. Fourteen women with childhood abuse and the current diagnosis of dissociative amnesia or dissociative identity disorder but without posttraumatic stress disorder (PTSD) and 14 matched healthy comparison subjects underwent functional magnetic resonance imaging (fMRI) while finding their way in a virtual maze. The virtual maze presented a first-person view (egocentric), lacked any topographical landmarks and could be learned only by using egocentric navigation strategies. Participants with dissociative disorders (DD) were not impaired in learning the virtual maze when compared with controls, and showed a similar, although weaker, pattern of activity changes during egocentric learning when compared with controls. Stronger dissociative disorder severity of participants with DD was related to better virtual maze performance, and to stronger activity increase within the cingulate gyrus and the precuneus. Our results add to the present knowledge of preserved attentional and visuospatial mnemonic functioning in individuals with DD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Negative autobiographical memories in social anxiety disorder: A comparison with panic disorder and healthy controls.

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O'Toole, Mia Skytte; Watson, Lynn A; Rosenberg, Nicole K; Berntsen, Dorthe

2016-03-01

Empirical interest in mental imagery in social anxiety disorder (SAD) has grown over the past years but still little is known about the specificity to SAD. The present study therefore examines negative autobiographical memories in participants with social anxiety disorder (SAD), compared to patients with panic disorder (PD), and healthy controls (HCs). A total of 107 participants retrieved four memories cued by verbal phrases associated with either social anxiety (SA) or panic anxiety (PA), with two memories for each cue category. PA-cued memories were experienced with stronger imagery and as more traumatic. They were also rated as more central to identity than SA-cued memories, but not among participants with SAD, who perceived SA-cued memories as equally central to their identity. When between-group effects were detected, participants with anxiety disorders differed from HCs, but not from each other. Central limitations include reliance on self-report measures, comorbidity in the anxiety disorder groups, and lack of a neutrally cued memory comparison. The findings align with models of SAD suggesting that past negative social events play a central role in this disorder. Future research is suggested to further explore the function of negative memories, not only in SAD, but also in other anxiety disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

59 UNIVERSALISING THE CONCEPT OF IDENTITY WITH ISLAMIC ...

African Journals Online (AJOL)

HP

above that the concept is not restricted to a particular discipline. Other angles ... the diagnosis of gender identity disorder, according to him, is a known ... national origin, language, religion, food and other cultural markers, according to ..... should be put in focus in order to avoid going off the tracks of faith, sincerity and.

Reliability generalization of the Multigroup Ethnic Identity Measure-Revised (MEIM-R).

Science.gov (United States)

Herrington, Hayley M; Smith, Timothy B; Feinauer, Erika; Griner, Derek

2016-10-01

[Correction Notice: An Erratum for this article was reported in Vol 63(5) of Journal of Counseling Psychology (see record 2016-33161-001). The name of author Erika Feinauer was misspelled as Erika Feinhauer. All versions of this article have been corrected.] Individuals' strength of ethnic identity has been linked with multiple positive indicators, including academic achievement and overall psychological well-being. The measure researchers use most often to assess ethnic identity, the Multigroup Ethnic Identity Measure (MEIM), underwent substantial revision in 2007. To inform scholars investigating ethnic identity, we performed a reliability generalization analysis on data from the revised version (MEIM-R) and compared it with data from the original MEIM. Random-effects weighted models evaluated internal consistency coefficients (Cronbach's alpha). Reliability coefficients for the MEIM-R averaged α = .88 across 37 samples, a statistically significant increase over the average of α = .84 for the MEIM across 75 studies. Reliability coefficients for the MEIM-R did not differ across study and participant characteristics such as sample gender and ethnic composition. However, consistently lower reliability coefficients averaging α = .81 were found among participants with low levels of education, suggesting that greater attention to data reliability is warranted when evaluating the ethnic identity of individuals such as middle-school students. Future research will be needed to ascertain whether data with other measures of aspects of personal identity (e.g., racial identity, gender identity) also differ as a function of participant level of education and associated cognitive or maturation processes. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Cross-sex pattern of bone mineral density in early onset gender identity disorder.

Science.gov (United States)

Haraldsen, I R; Haug, E; Falch, J; Egeland, T; Opjordsmoen, S

2007-09-01

Hormonally controlled differences in bone mineral density (BMD) between males and females are well studied. The effects of cross-sex hormones on bone metabolism in patients with early onset gender identity disorder (EO-GID), however, are unclear. We examined BMD, total body fat (TBF) and total lean body mass (TLBM) in patients prior to initiation of sex hormone treatment and during treatment at months 3 and 12. The study included 33 EO-GID patients who were approved for sex reassignment and a control group of 122 healthy Norwegians (males, n=77; females, n=45). Male patients (n=12) received an oral dose of 50 mug ethinylestradiol daily for the first 3 months and 100 mug daily thereafter. Female patients (n=21) received 250 mg testosterone enantate intramuscularly every third week. BMD, TBF and TLBM were estimated using dual energy X-ray absorptiometry (DXA). In male patients, the DXA measurements except TBF were significantly lower compared to their same-sex control group at baseline and did not change during treatment. In female patients, the DXA measurements were slightly higher than in same-sex controls at baseline and also remained unchanged during treatment. In conclusion, this study reports that body composition and bone density of EO-GID patients show less pronounced sex differences compared to controls and that bone density was unaffected by cross-sex hormone treatment.

Hepatocellular adenoma in a woman who was undergoing testosterone treatment for gender identity disorder.

Science.gov (United States)

Kato, Keizo; Abe, Hiroshi; Hanawa, Noriko; Fukuzawa, Junya; Matsuo, Ryota; Yonezawa, Takeshi; Itoh, Sadahiro; Sato, Yoshiyuki; Ika, Makiko; Shimizu, Shohei; Endo, Shinji; Hano, Hiroshi; Izu, Asami; Sugitani, Masahiko; Tsubota, Akihito

2018-03-27

A 32-year-old Japanese woman was admitted to our hospital for the diagnosis and treatment of multiple liver tumors. She had been receiving 125 mg testosterone enanthate every 2 weeks following female-to-male gender identity disorder (GID) diagnosis at 20 years of age. Ultrasonography, computed tomography, and magnetic resonance imaging showed 11 hepatic nodular tumors with a maximum diameter of 28 mm. Liver tumors with hepatocellular adenoma (HCA) were diagnosed with needle biopsy. Segmentectomy of the left lateral lobe including two lesions, subsegmentectomy of S6 including two lesions, enucleation of each tumor in S5 and S7, and open surgical radiofrequency ablation for each tumor in S4 and S7 were performed. Immunohistochemical specimens showed that the tumor cells were diffusely and strongly positive for glutamine synthetase and that the nuclei were ectopically positive for β-catenin. Thus, the tumors were diagnosed as β-catenin-activated HCA (b-HCA). Transcatheter arterial chemoembolization plus subsequent radiofrequency ablation was performed for the 3 residual lesions in S4 and S8. Although testosterone enanthate was being continued for GID, no recurrence was observed until at least 22 months after the intensive treatments. HCA development in such patients receiving testosterone should be closely monitored using image inspection.

Rorschach Assessment of Two Distinctive Personality States of a Person With Dissociative Identity Disorder.

Science.gov (United States)

Hartmann, Ellen; Benum, Kirsten

2017-12-13

This case study used test data from a patient with Dissociative Identity Disorder (DID; American Psychiatric Association, 2013 ) to illustrate how two main personality states of the patient ("Ann" and "Ben") seemed to function. The Rorschach Performance Assessment System (R-PAS; Meyer, Viglione, Mihura, Erard, & Erdberg, 2011 ) and the Inventory of Interpersonal Problems-Circumplex (IIP-64; Horowitz, Alden, Wiggins, & Pincus, 2000 ), administered to Ann and Ben in separate settings, exposed two diverse R-PAS and IIP-64 profiles. Ann's R-PAS profile suggested an intellectualized style of information processing with few indications of psychological problems. Ben's profile indicated severe perceptual, cognitive, and interpersonal difficulties combined with suspicion and anxiety. Ann's IIP-64 profile suggested minor interpersonal problems, whereas Ben's indicated serious relational difficulties. The findings were discussed in relation to the theory of trauma-related structural dissociation of the personality (van der Hart, Nijenhuis, & Steele, 2006 ), which implies an enduring split in the organization of the personality with more or less separate entities with their own sense of self, perception of the world, and ways of organizing emotional, cognitive, and social functions. The DID personality structure is seen as a defense strategy and as a pathway in the personality development producing serious psychological pain and symptoms.

Depression and consumption: psychopharmaceuticals, branding, and new identity practices.

Science.gov (United States)

Greenslit, Nathan

2005-12-01

As pharmaceuticals are moving from private patient-doctor conversations to public television and print advertisements, best-selling books, and top TV shows, as well as into everyday conversations around risk and illness, how people understand health, sickness, and their own identity is also changing. This paper explores some of these changes by unpacking some of the social, political, and personal layers that are complicating the production and marketing of prescription drugs, and that are transforming the identity practices around contested illness. I focus on Sarafem and premenstrual dysphoric disorder (the illness Sarafem was marketed for) as a case study.

Click-evoked otoacoustic emissions in children and adolescents with gender identity disorder.

Science.gov (United States)

Burke, Sarah M; Menks, Willeke M; Cohen-Kettenis, Peggy T; Klink, Daniel T; Bakker, Julie

2014-11-01

Click-evoked otoacoustic emissions (CEOAEs) are echo-like sounds that are produced by the inner ear in response to click-stimuli. CEOAEs generally have a higher amplitude in women compared to men and neonates already show a similar sex difference in CEOAEs. Weaker responses in males are proposed to originate from elevated levels of testosterone during perinatal sexual differentiation. Therefore, CEOAEs may be used as a retrospective indicator of someone's perinatal androgen environment. Individuals diagnosed with Gender Identity Disorder (GID), according to DSM-IV-TR, are characterized by a strong identification with the other gender and discomfort about their natal sex. Although the etiology of GID is far from established, it is hypothesized that atypical levels of sex steroids during a critical period of sexual differentiation of the brain might play a role. In the present study, we compared CEOAEs in treatment-naïve children and adolescents with early-onset GID (24 natal boys, 23 natal girls) and control subjects (65 boys, 62 girls). We replicated the sex difference in CEOAE response amplitude in the control group. This sex difference, however, was not present in the GID groups. Boys with GID showed stronger, more female-typical CEOAEs whereas girls with GID did not differ in emission strength compared to control girls. Based on the assumption that CEOAE amplitude can be seen as an index of relative androgen exposure, our results provide some evidence for the idea that boys with GID may have been exposed to lower amounts of androgen during early development in comparison to control boys.

The Survey personal and national identity between individual with cell phone addiction disorder and normal smartphone users

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Seyyed Salman Alavi

2018-02-01

Full Text Available Objective: Smart phones have rapidly become an integral, and for some, an essential communication device worldwide. The issue of identity has always been a subject of interest among psychologists. The present study was conducted to compare personal and national identity and their subscales between cell phone addicts and non-addicts.Method: In this cross-sectional study, 500 student cell phone users from various universities in Tehran were recruited using stratified sampling. Participants completed cell phone addiction questionnaires including Mobile Phone Problematic Use Scale (MPPUS, Cell Phone Dependency Questionnaire (CPDQ, Personal Identity Development Questionnaire, Extended Objective Measure of Ego Identity Status (EOMEIS and National Identity Questionnaire. Then, the subscales of these instruments were analyzed using SPSS Version 20.Results: Results of this study revealed significant differences between cell phone addicts and non-addicts in the scores of national identity, personal identity, and most subscales, except for some subscales (P<0.05. In addition, a negative and significant relationship was found between personal and national identity and cell phone addiction (r=-0.35, -0.33, respectively.On the other hand, after controlling for the confounder variables, we found that national identity had an effect on cell phone addiction(OR=0.05, CI=0.92-0.98.Conclusion: The results of this study indicated that cell phone overuse may be correlated with defects in some aspects of national and personal identity.

Identity processes as a predictor of memory beliefs in older adults.

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Hilgeman, Michelle M; Allen, Rebecca S; Carden, Keisha D

2017-07-01

The impact of identity processes (identity assimilation, identity accommodation, and identity balance) on memory beliefs was explored. Individually administered questionnaires (e.g. depressive symptoms, subjective health, identity processes, memory beliefs) and a brief neuropsychological assessment of cognitive abilities were completed during a one-time interview with 82 participants aged 58-92 years-old (M = 74.68, SD = 10.95). Forty (49.4%) identified their race as White/Caucasian, 38 (46.9%) identified their race as Black/African American, and 3 (3.7%) indicated no primary racial/ethnic group. Hierarchical regression analyses revealed that identity processes account for differences in memory beliefs beyond established predictors. Specifically, identity accommodation and identity balance predicted memory self-efficacy beyond depression and subjective health. These findings are congruent with identity process theory; however, the impact of identity assimilation in this population was unremarkable. Exploratory analyses also indicated that the identity processes have a stronger relationship to some domains of memory self-efficacy (i.e. anxiety, capacity) than others (i.e. perceived change, locus of control). Beliefs about memory and their integration into an adaptable, yet consistent self-concept are an important element of identity for aging individuals. Additional research is needed to determine the unique role of identity accommodation and identity balance in understanding cognitive functioning and ultimately the impact on potential clinical applications, such as related health-seeking behavior among older adults. Tailored interventions could be developed to facilitate optimal utilization of health care services at a time when early diagnosis of memory-related disorders is critical for future planning and care decisions.

Neurobiology of Gender Identity and Sexual Orientation.

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Roselli, Charles E

2017-12-06

Sexual identity and sexual orientation are independent components of a person's sexual identity. These dimensions are most often in harmony with each other and with an individual's genital sex, but not always. This review discusses the relationship of sexual identity and sexual orientation to prenatal factors that act to shape the development of the brain and the expression of sexual behaviors in animals and humans. One major influence discussed relates to organizational effects that the early hormone environment exerts on both gender identity and sexual orientation. Evidence that gender identity and sexual orientation are masculinized by prenatal exposure to testosterone and feminized in it absence is drawn from basic research in animals, correlations of biometric indices of androgen exposure and studies of clinical conditions associated with disorders in sexual development. There are, however, important exceptions to this theory that have yet to be resolved. Family and twin studies indicate that genes play a role, but no specific candidate genes have been identified. Evidence that relates to the number of older brothers implicates maternal immune responses as a contributing factor for male sexual orientation. It remains speculative how these influences might relate to each other and interact with postnatal socialization. Nonetheless, despite the many challenges to research in this area, existing empirical evidence makes it clear that there is a significant biological contribution to the development of an individual's sexual identity and sexual orientation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Panhypopituitarism in one identical twin: the effect of hormone replacement].

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Del Canho, Harrij; van Alfen-van der Velden, Janiëlle; del Canho, Riwka; Otten, Barto

2011-01-01

Panhypopituitarism in childhood is rare. It is even rarer if the disorder appears in a boy with an identical but healthy twin brother. In such a patient it is useful to study the consequences of the hormone disorder and the effect of hormone replacement. A 6-year-old boy saw a paediatrician because of short stature. He was much shorter than his identical twin brother and he had more abdominal fat mass and a smaller penis. Laboratory tests identified hypothyroidism of central origin, in combination with hypocortisolism and growth hormone deficiency. Hormonal replacement resulted in an improvement in growth rate. At the age of 15 years, testosterone therapy was introduced because puberty had not occurred and his growth rate was low. Finally the patient grew a few centimetres taller than his twin brother. In the first year of life, panhypopituitarism has no negative consequences for growth. After this point, growth is clearly delayed. With sufficient replacement growth can completely catch up.

[Obsessive-compulsive disorder. A hidden disorder].

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Haraldsson, Magnús

2015-02-01

Obsessive-compulsive disorder is a common and often chronic psychiatric illness that significantly interferes with the patient´s functioning and quality of life. The disorder is characterized by excessive intrusive and inappropriate anxiety evoking thoughts as well as time consuming compulsions that cause significant impairment and distress. The symptoms are often accompanied by shame and guilt and the knowledge of the general public and professional community about the disorder is limited. Hence it is frequently misdiagnosed or diagnosed late. There are indications that the disorder is hereditary and that neurobiological processes are involved in its pathophysiology. Several psychological theories about the causes of obsessive-compulsive disorder are supported by empirical evidence. Evidence based treatment is either with serotoninergic medications or cognitive behavioral therapy, particularly a form of behavioral therapy called exposure response prevention. Better treatment options are needed because almost a third of people with obsessive-compulsive disorder respond inadequatly to treatment. In this review article two cases of obsessive-compulsive disorder are presented. The former case is a young man with typical symptoms that respond well to treatment and the latter is a middle aged lady with severe treatment resistant symptoms. She underwent stereotactic implantation of electrodes and received deep brain stimulation, which is an experimental treatment for severe obsessive-compulsive disorder that does not respond to any conventional treatment. Landspitali University Hospital, Division of Psychiatry. Faculty of Medicine, University of Iceland.

Tobacco Use and Sexual Orientation in a National Cross-sectional Study: Age, Race/Ethnicity, and Sexual Identity-Attraction Differences.

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McCabe, Sean Esteban; Matthews, Alicia K; Lee, Joseph G L; Veliz, Phil; Hughes, Tonda L; Boyd, Carol J

2018-04-09

The purpose of this study is to determine the past-year prevalence estimates of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder based on sexual identity among U.S. adults, and to examine potential variations in these estimates by age, race/ethnicity, and sexual identity-attraction concordance/discordance. The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions collected data via in-person interviews with a cross-sectional nationally representative sample of non-institutionalized adults (response rate=60.1%) and analyses for the present study were conducted in 2017. Any past-year nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder were most prevalent among sexual minority-identified adults compared with heterosexual-identified adults, with notable variations based on sex, age, race/ethnicity, and sexual identity-attraction discordance. Elevated rates of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder among sexual minorities were most prevalent among younger lesbian women and gay men, and all age groups of bisexual men and women. The odds of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder were significantly greater among sexual identity-attraction discordant women and significantly lower among sexual identity-attraction discordant men. These findings provide valuable new information about sexual minority subgroups, such as self-identified bisexual older adults and sexual identity-attraction discordant women, that appear to be at higher risk for adverse smoking-related health consequences as a result of their elevated rates of cigarette smoking. Additional attention is warranted to examine these high-risk subpopulations prospectively and, if the results are replicated with larger samples, this information can be used to target smoking-cessation and lung cancer screening efforts. Copyright © 2018 American Journal of Preventive Medicine

[Gender identity disorder and related sexual behavior problems in children and adolescents: from the perspective of development and child psychiatry].

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Yamashita, Hiroshi

2013-01-01

The present paper reviews the theoretical and empirical literature on children and adolescents with gender identity disorder. The organizational framework underlying this review is one that presents gender behavior in children and adolescents as a continuum rather than as a dichotomy of normal versus abnormal categories. Theories of normative gender development, prevalence, assessment, developmental trajectories, and comorbidity were investigated. There is a greater fluidity and likelihood of change in the pre-pubertal period. It was reported that the majority of affected children had been eventually developing a homosexual orientation. As an approach to determine the prevalence of GID in clinical samples in our child psychiatry clinic, screening instruments that include items on cross-gender or cross-sex identification were used. We applied the Child Behavior Checklist (CBCL). Of the 113 items in the Japanese version of the CBCL, there are two measures of cross-gender identification: "behaves like opposite sex" and "wishes to be opposite sex." Like the other items, they are scored on a 3-point scale of: 0-not true, 1- somewhat true, and 2-very true. Our study of 323 clinically-referred children aged 4-15 years reported that, among the boys, 9.6% assigned a score of 1 (somewhat true) or a score of 2 (very true) to the two items. The corresponding rates for the clinically-referred girls were 24.5%. The item of diagnosis of GID in our clinical sample was significantly higher than in non-referred children, reported as 2-5% using the same method. Two clinical case histories of screened children are also presented. Both of them were diagnosed with PDDNOS. Together with the literature review, most of the gender-related symptoms in autistic spectrum disorders (ASD) could be related to the behavioral and psychological characteristics of autism as shown in case histories. ASD subjects in adolescence can sometimes develop a unique confusion of identity that occasionally

Hormonal treatment reduces psychobiological distress in gender identity disorder, independently of the attachment style.

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Colizzi, Marco; Costa, Rosalia; Pace, Valeria; Todarello, Orlando

2013-12-01

Gender identity disorder may be a stressful situation. Hormonal treatment seemed to improve the general health as it reduces psychological and social distress. The attachment style seemed to regulate distress in insecure individuals as they are more exposed to hypothalamic-pituitary-adrenal system dysregulation and subjective stress. The objectives of the study were to evaluate the presence of psychobiological distress and insecure attachment in transsexuals and to study their stress levels with reference to the hormonal treatment and the attachment pattern. We investigated 70 transsexual patients. We measured the cortisol levels and the perceived stress before starting the hormonal therapy and after about 12 months. We studied the representation of attachment in transsexuals by a backward investigation in the relations between them and their caregivers. We used blood samples for assessing cortisol awakening response (CAR); we used the Perceived Stress Scale for evaluating self-reported perceived stress and the Adult Attachment Interview to determine attachment styles. At enrollment, transsexuals reported elevated CAR; their values were out of normal. They expressed higher perceived stress and more attachment insecurity, with respect to normative sample data. When treated with hormone therapy, transsexuals reported significantly lower CAR (P treatment seemed to have a positive effect in reducing stress levels, whatever the attachment style may be. © 2013 International Society for Sexual Medicine.

[Favorable current prognosis after HLA-identical bone marrow transplantation for children with required severe aplastic anemia; evaluation of 30 years of bone marrow transplantation at the Leiden University Medical Center

NARCIS (Netherlands)

Steekelenburg, M. van; Weel-Sipman, M.H. van; Zwinderman, A.H.; Hoogerbrugge, P.M.; Vossen, J.M.J.J.; Egeler, R.M.

2002-01-01

OBJECTIVE: To evaluate the results of 30 years of allogeneic HLA-identical bone marrow transplantation (BMT) as the treatment for children with acquired severe aplastic anaemia. DESIGN: Retrospective, descriptive. METHOD: Of all patients who underwent an HLA-identical sibling-donor BMT for severe

Islamic Identity and Competitive Identities (Global, National and Ethnic Identity; A Case Study of Shiraz University Students

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Mohammadtaghi Iman

2013-06-01

Full Text Available The verse of holy Koran "verily the most honored of you in the sight of Allah is [he who is] the most virtuous of you" directly shows that in god's willing there is no superiority of a man or a group than others except those who have piety to god. In fact, the Islamic identity focuses on the superiority of piety among humans and does not focus on superiority of a man or a group that causes Islamic identity theoretically be against other competitive identities such as ethnic, global and national identity. Therefore, this research aims to study the relationship between Islamic identity and competitive identities (ethnic, national and global. In this way based on Sheldon Stryker theory and survey method, 431 students have elected and have analyzed. The results have shown that there was positive significant relationship between Islamic identity, national and ethnic identity, and negative significant relationship between Islamic identity and global identity. In addition, multivariate regression results have shown that the variables national and global identities have explained 45 percent of the variation of Islamic identity variable. The results shows that national and ethnic identity amplify the Islamic identity and they have positive relationship with it and in fact they are not a competitive identity for Islamic identity but global identity has negative relationship with Islamic identity and therefore it is a competitive identity for Islamic identity.

Self and identity in women with symptoms of borderline personality: A qualitative study

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Gillian Agnew

2016-03-01

Full Text Available Identity disturbance has been suggested to be a core feature of borderline personality disorder (BPD. However, there is little known about the identity of individuals with symptoms of BPD from the participant's perspective. This study availed of in-depth lightly structured life story interviews with five female participants. Thematic analysis was utilized to derive three themes of identity: connection, distance between us, and hurt and healing. Results provided support for multiple and flexible conceptualizations of identity in comparison to the idea of a unitary self/identity. Results also suggested that participants were able to establish differing connections to others ranging from disconnection to intimacy and care. Participants reported that their identities were impacted upon by historical and current family/relationship dysfunction, but life stories also illustrated the positive impact of healing relationship experiences. Findings provide support for psychological theories that consider a multiple and relational self/identity and the empowerment of healthy aspects of the self in BPD recovery. Studies that assess the association between insight and change may further our knowledge into this complex population.

The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID).

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Blom, Rianne M; van Wingen, Guido A; van der Wal, Sija J; Luigjes, Judy; van Dijk, Milenna T; Scholte, H Steven; Denys, Damiaan

2016-01-01

Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but evidence for a neuro-anatomical basis is sparse. We collected T1-weighted structural magnetic resonance imaging scans on a 3T scanner in eight individuals with BIID and 24 matched healthy controls, and analyzed the data using voxel-based morphometry. The results showed reduced grey matter volume in the left dorsal and ventral premotor cortices and larger grey matter volume in the cerebellum (lobule VIIa) in individuals with BIID compared to controls. The premotor cortex and cerebellum are thought to be crucial for the experience of body-ownership and the integration of multisensory information. Our results suggest that BIID is associated with structural brain anomalies and might result from a dysfunction in the integration of multisensory information, leading to the feeling of disunity between the mental and physical body shape.

Recalled and current gender role behavior, gender identity and sexual orientation in adults with Disorders/Differences of Sex Development.

Science.gov (United States)

Callens, Nina; Van Kuyk, Maaike; van Kuppenveld, Jet H; Drop, Stenvert L S; Cohen-Kettenis, Peggy T; Dessens, Arianne B

2016-11-01

The magnitude of sex differences in human brain and behavior and the respective contributions of biology versus socialization remain a topic of ongoing study in science. The preponderance of evidence attests to the notion that sexual differentiation processes are at least partially hormonally mediated, with high levels of prenatal androgens facilitating male-typed and inhibiting female-typed behaviors. In individuals with Disorders/Differences of Sex Development (DSD), hormonal profiles or sensitivities have been altered due to genetic influences, presumably affecting gender(ed) activity interests as well as gender identity development in a minority of the affected population. While continued postnatal androgen exposure in a number of DSD syndromes has been associated with higher rates of gender dysphoria and gender change, the role of a number of mediating and moderating factors, such as initial gender assignment, syndrome severity and clinical management remains largely unclear. Limited investigations of the associations between these identified influences and gendered development outcomes impede optimization of clinical care. Participants with DSD (n=123), recruited in the context of a Dutch multi-center follow-up audit, were divided in subgroups reflecting prenatal androgen exposure, genital appearance at birth and gender of rearing. Recalled childhood play and playmate preferences, gender identity and sexual orientation were measured with questionnaires and semi-structured interviews. Data were compared to those of control male (n=46) and female participants (n=79). The findings support that (a) prenatal androgen exposure has large effects on (gendered) activity interests, but to a much lesser extent on sexual orientation and that (b) initial gender of rearing remains a better predictor of gender identity contentedness than prenatal androgen exposure, beyond syndrome severity and medical treatment influences. Nonetheless, 3.3% of individuals with DSD in our

Age and gender identity in a perpetrators of sexual violence against children

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Dvoryanchikov N.V.

2016-01-01

Full Text Available The paper devoted to the age and gender identity among the perpetrators of sexual violence against children and discussed the factors lead to pathogenesis of abnormal sexual behavior against children. We have identified particularities of gender and age identity in perpetrators of violent sexual acts against children. It was noted that patients with a diagnosis of pedophilia have abnormalities mostly in cognitive structure of sexual identity, that is shown in undifferentiated age peculiarities of perception of self-image and gender and role stereotypes. These data allow assessing more accurately the abnormalities of sexual sphere, explaining the deviant behavior, as well as structure of age and sex self-identity in persons with the disorder of sexual desire in the form of pedophilia and take a step closer to understanding the mechanisms of abnormal choice of sexual object.

Professional identity of Korean nurse practitioners in the United States.

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Seo, Kumsook; Kim, Miyoung

2017-04-01

Despite nurse practitioners' (NPs) professional identity having important implications for the confirmation of nursing practice characteristics, few studies have examined the professional identity of NPs overlaid with the immigrant experience. The aim of this study was to explore the career characteristics of Korean nurse immigrants who became NPs in the United States. Seven Korean NPs in the United States underwent in-depth interviews from August 2013 to May 2015. Content analysis was employed for data analysis. Five themes were identified regarding their professional identity as NPs: patient-centered thinking, responsibility for patient care, dedicated life, diligence, and feelings of achievement. Of these, patient-centered thinking appeared to be the overriding theme. The findings add to nursing knowledge about immigrant nurses and their abilities and striving to develop into new roles in nursing. The participants focused on listening, interpersonal relationships, and education in patient care, which helped differentiate their roles from those of other healthcare professionals. Nurse managers should consider the study findings when making policies to assist immigrant nurses to acculturate into practice, and there is a need for the development of educational materials to guide and promote the NPs' professional role. ©2017 American Association of Nurse Practitioners.

Constructing nurses' professional identity through social identity theory.

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Willetts, Georgina; Clarke, David

2014-04-01

The profession of nursing continues to struggle with defining and clarifying its professional identity. The definitive recognition of nursing as a profession was the moving of training from the hospital apprentice model to the tertiary sector. However, this is only part of the story of professional identity in nursing. Once training finishes and enculturation into the workplace commences, professional identity becomes a complicated social activity. This paper proposes social identity theory as a valuable research framework to assist with clarifying and describing the professional identity of nurses. The paper outlines the key elements of a profession and then goes on to describe the main concepts of social identity theory. Lastly, a connection is made between the usefulness of using social identity theory in researching professional identity in nursing, recognizing the contextual nature of the social activity of the profession within its workplace environment. © 2013 Wiley Publishing Asia Pty Ltd.

Resolving an identity crisis: Implicit drinking identity and implicit alcohol identity are related but not the same.

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Ramirez, Jason J; Olin, Cecilia C; Lindgren, Kristen P

2017-09-01

Two variations of the Implicit Association Test (IAT), the Drinking Identity IAT and the Alcohol Identity IAT, assess implicit associations held in memory between one's identity and alcohol-related constructs. Both have been shown to predict numerous drinking outcomes, but these IATs have never been directly compared to one another. The purpose of this study was to compare these IATs and evaluate their incremental predictive validity. US undergraduate students (N=64, 50% female, mean age=21.98years) completed the Drinking Identity IAT, the Alcohol Identity IAT, an explicit measure of drinking identity, as well as measures of typical alcohol consumption and hazardous drinking. When evaluated in separate regression models that controlled for explicit drinking identity, results indicated that the Drinking Identity IAT and the Alcohol Identity IAT were significant, positive predictors of typical alcohol consumption, and that the Drinking Identity IAT, but not the Alcohol Identity IAT, was a significant predictor of hazardous drinking. When evaluated in the same regression models, the Drinking Identity IAT, but not the Alcohol Identity IAT, was significantly associated with typical and hazardous drinking. These results suggest that the Drinking Identity IAT and Alcohol Identity IAT are related but not redundant. Moreover, given that the Drinking Identity IAT, but not the Alcohol Identity IAT, incrementally predicted variance in drinking outcomes, identification with drinking behavior and social groups, as opposed to identification with alcohol itself, may be an especially strong predictor of drinking outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Leadership identities

DEFF Research Database (Denmark)

Holmgreen, Lise-Lotte

2018-01-01

Questioning the assumption that identities can be controlled through a shared organisational culture, the article explores the inculcation of a discourse of diversity into leadership identities in a Danish bank and building society. Thus, it intends to demonstrate that, on the one hand, discourse...... plays a significant role in identity construction and, on the other, that leaders’ constructions may have many sources of inspiration within and outside the organisation, emphasising that identity construction is a complex process in which organisational efforts to promote a common leadership identity...... to construct their leadership identities. While the respondents present comparable identities to the interviewer, the analysis reveals that the they draw on different discourses and employ a number of different discursive means to present this identity. This, the article argues, may be the result of a number...

Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth.

Science.gov (United States)

McClain, Zachary; Peebles, Rebecka

2016-12-01

Adolescence is a crucial period for emerging sexual orientation and gender identity and also body image disturbance and disordered eating. Body image distortion and disordered eating are important pediatric problems affecting individuals along the sexual orientation and gender identity spectrum. Lesbian, gay, bisexual, transgender (LGBT) youth are at risk for eating disorders and body dissatisfaction. Disordered eating in LGBT and gender variant youth may be associated with poorer quality of life and mental health outcomes. Pediatricians should know that these problems occur more frequently in LGBT youth. There is evidence that newer treatment paradigms involving family support are more effective than individual models of care. Copyright © 2016 Elsevier Inc. All rights reserved.

Embodiment Mediates the Relationship between Avoidant Attachment and Eating Disorder Psychopathology.

Science.gov (United States)

Monteleone, Alessio Maria; Castellini, Giovanni; Ricca, Valdo; Volpe, Umberto; De Riso, Francesco; Nigro, Massimiliano; Zamponi, Francesco; Mancini, Milena; Stanghellini, Giovanni; Monteleone, Palmiero; Treasure, Janet; Maj, Mario

2017-11-01

The overvaluation of body shape and weight of persons with eating disorders (EDs) is putatively explained by a disturbance in the way they experience their own body (embodiment). Moreover, attachment disorders seem to promote the use of body as source for self-definition. Therefore, we assessed the role of embodiment in the connection between attachment styles and ED psychopathology. One-hundred and thirteen ED patients and 117 healthy subjects completed the Identity and Eating Disorders (IDEA) Questionnaire, the Eating Disorder Inventory-2 (EDI-2) and the Experiences in Close Relationships Scale. Eating disorder patients displayed IDEA, EDI-2 and Experiences in Close Relationships scores significantly higher than controls. IDEA total and subtotal scores mediated entirely the influence of avoidant attachment on EDI-2 interoceptive awareness and impulsivity. These findings demonstrate a relationship between insecure attachment and disorders of identity and embodiment and point to embodiment as a possible mediator between avoidant attachment and specific ED psychopathological traits. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Differentiating normal and disordered personality using the General Assessment of Personality Disorder (GAPD).

Science.gov (United States)

Hentschel, Annett G; John Livesley, W

2013-05-01

Criteria to differentiate personality disorder from extremes of normal personality variations are important given growing interest in dimensional classification because an extreme level of a personality dimension does not necessarily indicate disorder. The DSM-5 proposed classification of personality disorder offers a definition of general personality disorder based on chronic interpersonal and self/identity pathology. The ability of this approach to differentiate personality disorder from other mental disorders was evaluated using a self-report questionnaire, the General Assessment of Personality Disorder (GAPD). This measure was administered to a sample of psychiatric patients (N = 149) from different clinical sub-sites. Patients were divided into personality disordered and non-personality disordered groups on the basis of the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). The results showed a hit rate of 82% correct identified patients and a good accuracy of the predicted model. There was a substantial agreement between SCID-II interview and GAPD personality disorder diagnoses. The GAPD appears to predict personality disorder in general, which provides support of the DSM-5 general diagnostic criteria of personality disorder. Copyright © 2012 John Wiley & Sons, Ltd.

Reproducing the hierarchy of disorder for Morpho-inspired, broad-angle color reflection

DEFF Research Database (Denmark)

Song, Bokwang; Johansen, Villads Egede; Sigmund, Ole

2017-01-01

on the positional disorder among the identical, multilayered ridges as the critical factor for producing angular independent color. Realizing such positional disorder of identical nanostructures is difficult, which in turn has limited experimental verification of different physical mechanisms that have been...... proposed. In this paper, we suggest an alternative model of inter-structural disorder that can achieve the same broad-angle color reflection, and is applicable to wafer-scale fabrication using conventional thin film technologies. Fabrication of a thin film that produces pure, stable blue across a viewing...... angle of more than 120 ° is demonstrated, together with a robust, conformal color coating....

Autobiographical memory in borderline personality disorder-A systematic review.

Science.gov (United States)

Bech, Morten; Elklit, Ask; Simonsen, Erik

2015-05-01

Borderline personality disorder is a severe psychiatric illness. A key feature of the disorder is a disorganized sense of self often referred to as identity diffusion. Autobiographical memory is memory for personal life events. One of the main functions of these memories is to enable us to understand who we are by connecting past, present and future experiences. It seems that autobiographical memory is in some way disrupted in individuals with borderline personality disorder. A systematic review is conducted looking at studies that focus on the potential connections. We find that although a number of studies have been published results remain inconsistent. Furthermore, we find that many of the studies suffer from inadequate designs particularly regarding the reported measures of autobiographical memory. We discuss potential links between personality functioning, identity diffusion, autobiographical memory and borderline personality disorder. Copyright © 2015 John Wiley & Sons, Ltd.

Cervical Musculoskeletal Impairments and Temporomandibular Disorders

OpenAIRE

Susan Armijo-Olivo; David Magee

2012-01-01

ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maxima...

Eating disorders in college men.

Science.gov (United States)

Olivardia, R; Pope, H G; Mangweth, B; Hudson, J I

1995-09-01

This study was designed to assess the characteristics of men with eating disorders in the community. The authors recruited 25 men meeting DSM-IV criteria for eating disorders and 25 comparison men through advertisements in college newspapers. A second comparison group comprised 33 women with bulimia nervosa who were recruited and interviewed with virtually identical methods. The men with eating disorders closely resembled the women with eating disorders but differed sharply from the comparison men in phenomenology of illness, rates of comorbid psychiatric disorders, and dissatisfaction with body image. Homosexuality did not appear to be a common feature of men with eating disorders in the community. Childhood physical and sexual abuse appeared slightly more common among the eating-disordered men than among the comparison men. Eating disorders, although less common in men than in women, appear to display strikingly similar features in affected individuals of the two genders.

Eating disorders and disordered weight and shape control behaviors in sexual minority populations

Science.gov (United States)

Calzo, Jerel P.; Blashill, Aaron J.; Brown, Tiffany A.; Argenal, Russell L.

2017-01-01

Purpose of review This review summarized trends and key findings from empirical studies conducted between 2011–2017 regarding eating disorders and disordered weight and shape control behaviors among lesbian, gay, bisexual, and other sexual minority (i.e., non-heterosexual) populations. Recent findings Recent research has examined disparities through sociocultural and minority stress approaches. Sexual minorities continue to demonstrate higher rates of disordered eating; disparities are more pronounced among males. Emerging data indicates elevated risk for disordered eating pathology among sexual minorities who are transgender or ethnic minorities. Dissonance-based eating disorder prevention programs may hold promise for sexual minority males. Summary Continued research must examine the intersections of sexual orientation, gender, and ethnic identities, given emergent data that eating disorder risk may be most prominent among specific subgroups. More research is needed within sexual minorities across the lifespan. There are still a lack of eating disorder treatment and prevention studies for sexual minorities. PMID:28660475

Identity at work: Exploring strategies for Identity Work

Directory of Open Access Journals (Sweden)

Byron G. Adams

2012-01-01

Full Text Available Orientation: This study explored strategies for identity work that are central to the negotiation and regulation of employee work identity.Research purpose: The main aim of this study was to explore employee narratives and identify the strategies available to them in the process of identity work, as they defined themselves at work.Motivation for the study: As there is a scarcity of research on identity work in South Africa, this study wanted to advance knowledge about identity work and the strategies used for regulating and negotiating an identity at work by exploring these constructs in this context.Research design, approach and method: A qualitative research process formed the basis for this study. Nineteen employees from a global manufacturing company participated in two semi-structured in-depth interviews. Grounded theory was applied to analyse and interpret the data.Main findings: Nine strategies for identity work were identified and categorised into four broad themes (personal philosophies; relationships; career management and negotiating balance.Practical/managerial implications: Employees followed various strategies for defining themselves at work and this may have some implications for employee work engagement and productivity.Contribution/value-add: This study expands on current theoretical knowledge of identity work, and provides insights into the strategies people use to regulate and negotiate their identities at work. 

The neuron identity problem: form meets function.

Science.gov (United States)

Fishell, Gord; Heintz, Nathaniel

2013-10-30

A complete understanding of nervous system function cannot be achieved without the identification of its component cell types. In this Perspective, we explore a series of related issues surrounding cell identity and how revolutionary methods for labeling and probing specific neuronal types have clarified this question. Specifically, we ask the following questions: what is the purpose of such diversity, how is it generated, how is it maintained, and, ultimately, how can one unambiguously identity one cell type from another? We suggest that each cell type can be defined by a unique and conserved molecular ground state that determines its capabilities. We believe that gaining an understanding of these molecular barcodes will advance our ability to explore brain function, enhance our understanding of the biochemical basis of CNS disorders, and aid in the development of novel therapeutic strategies. Copyright © 2013 Elsevier Inc. All rights reserved.

Evolution of elderly patients who underwent cardiac surgery with cardiopulmonary bypass

Directory of Open Access Journals (Sweden)

Alain Moré Duarte

2016-01-01

Full Text Available Introduction: There is a steady increase in the number of elderly patients with severe cardiovascular diseases who require a surgical procedure to recover some quality of life that allows them a socially meaningful existence, despite the risks.Objectives: To analyze the behavior of elderly patients who underwent cardiac surgery with cardiopulmonary bypass.Method: A descriptive, retrospective, cross-sectional study was conducted with patients over 65 years of age who underwent surgery at the Cardiocentro Ernesto Che Guevara, in Santa Clara, from January 2013 to March 2014.Results: In the study, 73.1% of patients were men; and there was a predominance of subjects between 65 and 70 years of age, accounting for 67.3%. Coronary artery bypass graft was the most prevalent type of surgery and had the longest cardiopulmonary bypass times. Hypertension was present in 98.1% of patients. The most frequent postoperative complications were renal dysfunction and severe low cardiac output, with 44.2% and 34.6% respectively.Conclusions: There was a predominance of men, the age group of 65 to 70 years, hypertension, and patients who underwent coronary artery bypass graft with prolonged cardiopulmonary bypass. Renal dysfunction was the most frequent complication.

Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample.

Science.gov (United States)

Diemer, Elizabeth W; White Hughto, Jaclyn M; Gordon, Allegra R; Guss, Carly; Austin, S Bryn; Reisner, Sari L

2018-01-01

Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18-75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent). Results: The age-adjusted odds of self-reported ED in MTF participants were 0.14 times the odds of self-reported ED in FBGNC participants ( p =0.022). In FTM participants, the age-adjusted odds of self-reported ED were 0.46 times the odds of self-reported ED in FBGNC participants, a marginally significant finding ( p =0.068). No statistically significant differences in ED prevalence were found for MBGNC individuals. Conclusions: Gender nonconforming individuals assigned a female sex at birth appear to have heightened lifetime risk of EDs relative to MTF participants. Further research into specific biologic and psychosocial ED risk factors and gender-responsive intervention strategies are urgently needed. Training clinical providers and ensuring competency of treatment services beyond the gender binary will be vital to addressing this disparity.

Beyond the Binary: Differences in Eating Disorder Prevalence by Gender Identity in a Transgender Sample

Science.gov (United States)

Diemer, Elizabeth W.; White Hughto, Jaclyn M.; Gordon, Allegra R.; Guss, Carly; Austin, S. Bryn; Reisner, Sari L.

2018-01-01

Abstract Purpose: To investigate whether the prevalence of eating disorders (EDs) differs across diverse gender identity groups in a transgender sample. Methods: Secondary analysis of data from Project VOICE, a cross-sectional study of stress and health among 452 transgender adults (ages 18–75 years) residing in Massachusetts. Age-adjusted logistic regression models were fit to compare the prevalence of self-reported lifetime EDs in female-to-male (FTM), male-to-female (MTF), and gender-nonconforming participants assigned male at birth (MBGNC) to gender-nonconforming participants assigned female at birth (FBGNC; referent). Results: The age-adjusted odds of self-reported ED in MTF participants were 0.14 times the odds of self-reported ED in FBGNC participants (p=0.022). In FTM participants, the age-adjusted odds of self-reported ED were 0.46 times the odds of self-reported ED in FBGNC participants, a marginally significant finding (p=0.068). No statistically significant differences in ED prevalence were found for MBGNC individuals. Conclusions: Gender nonconforming individuals assigned a female sex at birth appear to have heightened lifetime risk of EDs relative to MTF participants. Further research into specific biologic and psychosocial ED risk factors and gender-responsive intervention strategies are urgently needed. Training clinical providers and ensuring competency of treatment services beyond the gender binary will be vital to addressing this disparity. PMID:29359198

Identity, identity politics, and neoliberalism

Directory of Open Access Journals (Sweden)

Wrenn Mary

2014-01-01

Full Text Available With the intensification of neoliberalism, it is useful to examine how some individuals might cope with the irrationality of the system. Neoliberalism cloaks the execution of the corporate agenda behind rhetorical manipulation that advocates for limited government. The corollary absence of government involvement on behalf of the citizenry writ large disarms the means of social redress for the individual. Democracy funded and fueled by corporate power thereby disenfranchises the individual, provoking some to search for empowerment through identity politics. The argument set forth suggests that individuals construct, reinforce, or escalate allegiance to identities as a coping mechanism, some of which manifest in violent identity politics.

The Process of Identity Work: Negotiating a Work Identity

NARCIS (Netherlands)

Crafford, A.; Adams, B.G.; Saayman, T.; Vinkenburg, C.J.; Jansen, P.G.W.; Roodt, G.

2015-01-01

Identity work is an important process in negotiating, regulating and maintaining a coherent sense of self-(identity). In this chapter we discuss how identity work is particularly useful in establishing a work identity. The crux of the discussion in this chapter is based on the qualitative phase of

Cultural Identity Among Afghan and Iraqi Traumatized Refugees: Towards a Conceptual Framework for Mental Health Care Professionals.

Science.gov (United States)

Groen, Simon P N; Richters, Annemiek; Laban, Cornelis J; Devillé, Walter L J M

2018-03-01

Cultural identity in relation with mental health is of growing interest in the field of transcultural psychiatry. However, there is a need to clarify the concept of cultural identity in order to make it useful in clinical practice. The purpose of this study is to unravel the complexity and many layers of cultural identity, and to assess how stress and acculturation relate to (changes in) cultural identity. As part of a larger study about cultural identity, trauma, and mental health, 85 patients from Afghanistan and Iraq in treatment for trauma-related disorders were interviewed with a Brief Cultural Interview. The interviews were analysed through qualitative data analysis using the procedures of grounded theory. The analysis resulted in three domains of cultural identity: personal identity, ethnic identity and social identity. Within each domain relationships with stress and acculturation were identified. The results offer insight into the intensity of changes in cultural identity, caused by pre-and post-migration stressors and the process of acculturation. Based on the research findings recommendations are formulated to enhance the cultural competency of mental health workers.

Medical Identity

DEFF Research Database (Denmark)

Musaeus, Peter

2015-01-01

Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

symptomatology and comorbidity of somatization disorder amongst

African Journals Online (AJOL)

underlying mental disorder, manifesting solely as somatic symptoms or with ... unsatisfactory visit and seemingly ineffective treatment plan. ... patients of all ages and both gender with various ..... identity and physical health: Interdisciplinary.

Distinct facial processing in schizophrenia and schizoaffective disorders

Science.gov (United States)

Chen, Yue; Cataldo, Andrea; Norton, Daniel J; Ongur, Dost

2011-01-01

Although schizophrenia and schizoaffective disorders have both similar and differing clinical features, it is not well understood whether similar or differing pathophysiological processes mediate patients’ cognitive functions. Using psychophysical methods, this study compared the performances of schizophrenia (SZ) patients, patients with schizoaffective disorder (SA), and a healthy control group in two face-related cognitive tasks: emotion discrimination, which tested perception of facial affect, and identity discrimination, which tested perception of non-affective facial features. Compared to healthy controls, SZ patients, but not SA patients, exhibited deficient performance in both fear and happiness discrimination, as well as identity discrimination. SZ patients, but not SA patients, also showed impaired performance in a theory-of-mind task for which emotional expressions are identified based upon the eye regions of face images. This pattern of results suggests distinct processing of face information in schizophrenia and schizoaffective disorders. PMID:21868199

Identity at work: Exploring strategies for Identity Work

Directory of Open Access Journals (Sweden)

Byron G. Adams

2012-09-01

Research purpose: The main aim of this study was to explore employee narratives and identify the strategies available to them in the process of identity work, as they defined themselves at work. Motivation for the study: As there is a scarcity of research on identity work in South Africa, this study wanted to advance knowledge about identity work and the strategies used for regulating and negotiating an identity at work by exploring these constructs in this context. Research design, approach and method: A qualitative research process formed the basis for this study. Nineteen employees from a global manufacturing company participated in two semi-structured in-depth interviews. Grounded theory was applied to analyse and interpret the data. Main findings: Nine strategies for identity work were identified and categorised into four broad themes (personal philosophies; relationships; career management and negotiating balance. Practical/managerial implications: Employees followed various strategies for defining themselves at work and this may have some implications for employee work engagement and productivity. Contribution/value-add: This study expands on current theoretical knowledge of identity work, and provides insights into the strategies people use to regulate and negotiate their identities at work.

Determinant factors of gender identity: a commentary.

Science.gov (United States)

Liao, Lih-Mei; Audi, Laura; Magritte, Ellie; Meyer-Bahlburg, Heino F L; Quigley, Charmian A

2012-12-01

Paediatric specialists involved in the care of children with disorders of sex development may be expected to provide straightforward answers to questions concerning the "true sex" of a child, reflecting common perceptions of sex/gender as an immutable binary biological reality. This article highlights how much more broad and complex the topic of gender identity and its development is. Many theories have been put forward to advance knowledge of gender identity. Against the breadth and depth of this vast topic, the current overview is inevitably incomplete. It begins by arguing for a more consistent use of 'sex' and 'gender'. It considers in turn three influential theoretical frameworks that lend themselves to empirical research. These are: 1) the role of the brain; 2) the role of socialisation; and 3) multi-dimensional gender development. The article ends by suggesting potentially fruitful questions and areas for future research. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Identity paradoxes

Directory of Open Access Journals (Sweden)

Đurić Jelena

2010-01-01

Full Text Available The article considers paradoxical nature of identity that emerges from: 1 the very concept of identity whose abstract generality unites various and even opposite features; 2 the processual nature of reality that is easier to express in the poetical metaphors or abstract principles than in unambiguous conceptual networks; 3 the oppose relationship between being and knowledge, mind and matter, subject and object, self and personality. Entangled in the labyrinth which evade efforts to be conceptually defined, the modern thinking of identity moves towards abandoning the idea of “self” on behalf of the “ego” and towards the misapprehension of identity as being identical. This corresponds to the “time of the lost spirit” stretched between the simultaneous need to find an identity and to give it up.

Federated Identity Management

OpenAIRE

Chadwick, David W.

2009-01-01

Abstract. This paper addresses the topic of federated identity management. It discusses in detail the following topics: what is digital identity, what is identity management, what is federated identity management, Kim Camerons 7 Laws of Identity, how can we protect the users privacy in a federated environment, levels of assurance, some past and present federated identity management systems, and some current research in FIM.

Social identity change: shifts in social identity during adolescence.

Science.gov (United States)

Tanti, Chris; Stukas, Arthur A; Halloran, Michael J; Foddy, Margaret

2011-06-01

This study investigated the proposition that adolescence involves significant shifts in social identity as a function of changes in social context and cognitive style. Using an experimental design, we primed either peer or gender identity with a sample of 380 early- (12-13 years), mid- (15-16 years), and late-adolescents (18-20 years) and then measured the effect of the prime on self-stereotyping and ingroup favouritism. The findings showed significant differences in social identity across adolescent groups, in that social identity effects were relatively strong in early- and late-adolescents, particularly when peer group identity rather than gender identity was salient. While these effects were consistent with the experience of change in educational social context, differences in cognitive style were only weakly related to ingroup favouritism. The implications of the findings for theory and future research on social identity during adolescence are discussed. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Comparative Associations Between Achieved Bicultural Identity, Achieved Ego Identity, and Achieved Religious Identity and Adaptation Among Australian Adolescent Muslims.

Science.gov (United States)

Abu-Rayya, Hisham M; Abu-Rayya, Maram H; White, Fiona A; Walker, Richard

2018-04-01

This study examined the comparative roles of biculturalism, ego identity, and religious identity in the adaptation of Australian adolescent Muslims. A total of 504 high school Muslim students studying at high schools in metropolitan Sydney and Melbourne, Australia, took part in this study which required them to complete a self-report questionnaire. Analyses indicated that adolescent Muslims' achieved religious identity seems to play a more important role in shaping their psychological and socio-cultural adaptation compared to adolescents' achieved bicultural identity. Adolescents' achieved ego identity tended also to play a greater role in their psychological and socio-cultural adaptation than achieved bicultural identity. The relationships between the three identities and negative indicators of psychological adaptation were consistently indifferent. Based on these findings, we propose that the three identity-based forces-bicultural identity development, religious identity attainment, and ego identity formation-be amalgamated into one framework in order for researchers to more accurately examine the adaptation of Australian adolescent Muslims.

Swiss identity smells like chocolate: Social identity shapes olfactory judgments

Science.gov (United States)

Coppin, Géraldine; Pool, Eva; Delplanque, Sylvain; Oud, Bastiaan; Margot, Christian; Sander, David; Van Bavel, Jay J.

2016-01-01

There is extensive evidence that social identities can shape people’s attitudes and behavior, but what about sensory judgments? We examined the possibility that social identity concerns may also shape the judgment of non-social properties—namely, olfactory judgment. In two experiments, we presented Swiss and non-Swiss participants with the odor of chocolate, for which Switzerland is world-famous, and a control odor (popcorn). Swiss participants primed with Swiss identity reported the odor of chocolate (but not popcorn) as more intense than non-Swiss participants (Experiments 1 and 2) and than Swiss participants primed with individual identity or not primed (Experiment 2). The self-reported intensity of chocolate smell tended to increase as identity accessibility increased—but only among Swiss participants (Experiment 1). These results suggest that identity priming can counter-act classic sensory habituation effects, allowing identity-relevant smells to maintain their intensity after repeated presentations. This suggests that social identity dynamically influences sensory judgment. We discuss the potential implications for models of social identity and chemosensory perception. PMID:27725715

Swiss identity smells like chocolate: Social identity shapes olfactory judgments.

Science.gov (United States)

Coppin, Géraldine; Pool, Eva; Delplanque, Sylvain; Oud, Bastiaan; Margot, Christian; Sander, David; Van Bavel, Jay J

2016-10-11

There is extensive evidence that social identities can shape people's attitudes and behavior, but what about sensory judgments? We examined the possibility that social identity concerns may also shape the judgment of non-social properties-namely, olfactory judgment. In two experiments, we presented Swiss and non-Swiss participants with the odor of chocolate, for which Switzerland is world-famous, and a control odor (popcorn). Swiss participants primed with Swiss identity reported the odor of chocolate (but not popcorn) as more intense than non-Swiss participants (Experiments 1 and 2) and than Swiss participants primed with individual identity or not primed (Experiment 2). The self-reported intensity of chocolate smell tended to increase as identity accessibility increased-but only among Swiss participants (Experiment 1). These results suggest that identity priming can counter-act classic sensory habituation effects, allowing identity-relevant smells to maintain their intensity after repeated presentations. This suggests that social identity dynamically influences sensory judgment. We discuss the potential implications for models of social identity and chemosensory perception.

Can the DSM-5 differentiate between nonpathological possession and dissociative identity disorder? A case study from an Afro-Brazilian religion.

Science.gov (United States)

Delmonte, Romara; Lucchetti, Giancarlo; Moreira-Almeida, Alexander; Farias, Miguel

2016-01-01

The aim of this article is to examine whether the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are able to differentiate between nonpathological religious possession and dissociative identity disorder (DID). We use the case study of an individual who leads an Afro-Brazilian religious group (Umbanda), focusing on her personal development and possession experiences from early childhood to the present, spanning a period of more than 40 years, and examine these data following DSM-5 criteria for DID (300.14). Her experiences of possession can be broken into 2 distinct stages. In the 1st stage (childhood and early adulthood), she displayed intrusive thoughts and a lack of control over possession states, which were associated with a heightened state of anxiety, loneliness, amnesia, and family conflict (meeting all 5 criteria for DID). In the 2nd stage (late 20s up to the present), she regularly experienced possession states but felt in control of their onset and found them religiously meaningful. In this 2nd stage, she only fulfilled 3 criteria for DID. We question the accuracy of diagnosing this individual with DID in her earlier life and suggest that the DSM-5 criteria fail to address the ambiguity of affect surrounding possession experiences (positive at the individual level, negative at the interpersonal level) and lack a clearer acknowledgment of the prevalence of possession and other unusual experiences in general populations.

[What is "normal"? Maternal parenting behavior as risk and protective factor for psychopathology and identity diffusion].

Science.gov (United States)

Seiffge-Krenke, Inge; Escher, Fabian J

2018-06-01

What is "normal"? Maternal parenting behavior as risk and protective factor for psychopathology and identity diffusion Objectives: This study analyzes the implications of today's highly altered maternal parenting behaviors on children's development and psychological health. The relationship between maternal parenting behaviors (support, psychological control, and anxious monitoring) and delayed identity development or identity diffusion as well as internalizing or externalizing symptomatology was investigated in a sample of 732 youths (301 adolescents, 351 young adults, and 80 patients). Cluster analysis identified two types of maternal parenting behaviors: authoritative maternal behavior and dysfunctionalmaternal behavior. As expected, patients exhibited a high degree of dysfunctional maternal parenting behavior (low support, high psychological control), delayed identity development as well as elevated identity diffusion and symptomatology.Authoritative maternal parenting emerged as a protective factor in the prediction of identity diffusion and symptomatology.All three groups described a high degree of anxious maternal monitoring. The implications of changed maternal parenting behaviors on identity diffusion and symptomatology are discussed in light of societal changes and changing criteria of personality disorders in the new DSM-5.

[About the heterogeneity in adolescents with gender identity disorder: differential importance of psychiatric comorbidity and considerations of individual psychodynamics].

Science.gov (United States)

Korte, Alexander; Beier, Klaus M; Vukorepa, Julia; Mersmann, Maik; Albiez, Verena

2014-01-01

Gender identity disorder (GID), gender dysphoria (GD) respectively, is considered a multifactorial disease whose etiology is subject to complex bio-psycho-social conditions, each with different weighting. As a result, therapists, who treat children and adolescents with GID/GD, have to deal with a very heterogeneous group with individually varying causes, differing psychopathology and varying disease progression. In addition to general psychiatric aspects of development, particularly psychiatric comorbidity, but also the different individual psychodynamics--i. e. the specific constellation of conflicts and possible ego deficits and structural deficits in the learning history of the person are of differential importance. In regard to the indication for gender reassignment measures this sometimes is relevant for the decision. The difficulties arising for decision making and the usefulness of a systematic evaluation of case reports as a basis for further optimization of the treatment recommendations are illustrated by two case reports. In the course of this, also the disadvantages and potential dangers of too early diagnostic definition and introduction of gender somato-medical and legal measures are shown exemplarily.

Megarectumsigma underwent surgery for chronic faecal impact action

International Nuclear Information System (INIS)

Canessa, C.; Gomez del Valle, M.; Caraballo, M.

2002-01-01

Seven patients with megarectumsigma underwent surgery for chronic faecal impaction,reviewing clinical diagnosis, aetiology and medical and surgical management.It is suggested medical management of chronic faecal impaction trying to achieve elective surgery.The curative surgery should include the resection of all pathologic bowel, but in Duhamel procedure and its modifications distal rectal tran section should be at the peritoneal reflection.Habr-Gama modification has shown to be technically easier and it has been communicated good functional results.Local unfavourable conditions may be resolve by staged surgery,which allows outline definitive bowel reconstruction after functional assessment

Development of schizotypal symptoms following psychiatric disorders in childhood or adolescence.

Science.gov (United States)

Fagel, Selene S A A; Swaab, Hanna; De Sonneville, Leo M J; Van Rijn, Sophie; Pieterse, Jolijn K; Scheepers, Floor; Van Engeland, Herman

2013-11-01

It was examined how juvenile psychiatric disorders and adult schizotypal symptoms are associated. 731 patients of the Department of Child and Adolescent Psychiatry of the University Medical Centre Utrecht, the Netherlands, with mean age of 12.1 years (SD = 4.0) were reassessed at the mean age of 27.9 years (SD = 5.7) for adult schizotypal symptoms using the Schizotypal Personality Questionnaire-Revised (Vollema, Schizophr Bull 26(3):565-575, 2000). Differences between 13 juvenile DSM categories and normal controls (n = 80) on adult schizotypal total and factor scores were analyzed, using (M)ANCOVA. Pervasive developmental disorders (PDD), attention deficit hyperactivity disorders (ADHD), deferred diagnosis, sexual and gender identity disorders and depressive disorders had higher SPQ total scores when compared to normal controls (p gender identity disorders, depressive disorders, disruptive disorders, and the category of 'Other conditions that may be a focus of clinical attention' (p < 0.001). No differences with normal controls were found for adult positive schizotypal symptoms (p < 0.110). The current findings are suggestive of the idea that psychiatric disorders in childhood or adolescence are a more general expression of a liability to schizophrenia spectrum pathology in future life. In addition, specific patterns of adult schizotypal symptomatology are associated with different types of juvenile psychiatric disorder.

The Supermalt identity

DEFF Research Database (Denmark)

Bech-Larsen, Tino; Esbjerg, Lars; Grunert, Klaus G.

2007-01-01

on consumers' self-identities. The second part explored the role of food and beverage products in the construction of self-identities. The final part focused on the construction of brand identity for Supermalt. Findings - The article provides information on the self-identities constructed by Afro......-Caribbean informants. The food and beverage consumption of informants reflects their mixed cultural identity. The brand identity Supermalt appears to be malleable, with ample room for consumer co-construction. Perceptions of brand identity differ markedly among informants, who are all able to construct Supermalt......Purpose - The objective of this article is to conduct a case study of the Supermalt brand of malt beer, which has become the preferred beverage of Afro-Caribbean consumers in Brixton on a very limited marketing budget. Design/methodology/approach - The article uses the concepts of personal identity...

Fashioning Identity

DEFF Research Database (Denmark)

Mackinney-Valentin, Maria

We dress to communicate who we are, or who we would like others to think we are, telling seductive fashion narratives through our adornment. Yet, today, fashion has been democratized through high-low collaborations, social media and real-time fashion mediation, complicating the basic dynamic...... of identity displays, and creating tension between personal statements and social performances. Fashioning Identity explores how this tension is performed through fashion production and consumption,by examining a diverse series of case studies - from ninety-year old fashion icons to the paradoxical rebellion...... by readdressing Fred Davis' seminal concept of 'identity ambivalence' in Fashion, Culture and Identity (1992), Mackinney-Valentin argues that we are in an epoch of 'status ambivalence', in which fashioning one's own identity has become increasingly complicated....

Pattern and predictors of psychosocial disorders among overweight ...

African Journals Online (AJOL)

Psychosocial disorders negatively impact on children. Objectives. This study aims to ..... personality development in which they develop self-identity. This ..... esteem is related to aggression, antisocial behavior and delinquency. Psychol Sci.

Neurodiversity: Autism Pride among Mothers of Children with Autism Spectrum Disorders

Science.gov (United States)

Cascio, M. Ariel

2012-01-01

The neurodiversity movement takes an identity politics approach to autism spectrum disorders, proposing autism spectrum disorders as a positive "neuro-variation" to be approached only with interventions that assist individuals without changing them. This article explicates the concept of "neurodiversity" and places it within…

Rebuilding lives and identities: The role of place in recovery among persons with complex needs.

Science.gov (United States)

Tran Smith, Bikki; Padgett, Deborah K; Choy-Brown, Mimi; Henwood, Benjamin F

2015-05-01

Photo-elicitation interviews (PEIs) were conducted to explore the role of place in recovery - specifically, narrative identity reconstruction - among persons with complex needs. PEIs with 17 formerly homeless adults with co-occurring disorders in New York City produced 243 photos. Content analysis of photos revealed three categories - apartment, neighborhood and people. Two narrative themes - having my own and civic identity - were mapped onto the apartment and neighborhood categories, respectively. Three additional cross-categorical narrative themes were identified: (re)negotiating relationships and boundaries, moving beyond old identities and future possibilities. Housing was central across themes. Understanding of recovery is enhanced when viewed through participant-controlled visual methods. Copyright © 2015 Elsevier Ltd. All rights reserved.

High psychiatric comorbidity in adolescents with dissociative disorders.

Science.gov (United States)

Bozkurt, Hasan; Duzman Mutluer, Tuba; Kose, Cigdem; Zoroglu, Salih

2015-06-01

The aim of this study was to evaluate psychiatric comorbidity rates and patterns in a sample of clinically referred adolescents diagnosed with dissociative disorders (DD) by using a structured interview. All participants completed a comprehensive test battery, which consisted of a questionnaire for sociodemographic data and clinical history, Child Posttraumatic Stress Reaction Index, Childhood Abuse and Neglect Questionnaire and the Adolescent Dissociative Experiences Scale. Diagnosis was made by the Structured Clinical Interview for DSM-IV Dissociative Disorders. Psychiatric comorbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version. A total of 25 adolescent subjects aged 12-18 years participated in the study. Ten adolescents were diagnosed as having dissociative identity disorder and 15 of them were diagnosed as having dissociative disorder-not otherwise specified based on the Structured Clinical Interview for DSM-IV Dissociative Disorders findings. Adolescents with dissociative identity disorder were found to have higher scores on the Adolescent Dissociative Experiences Scale and Child Posttraumatic Stress Reaction Index than the dissociative disorder-not otherwise specified group. Sexual and physical abuses were also found to be among the main traumatic events. Incest was reported in six cases of the study sample. All subjects had at least one comorbid psychiatric disorder. The most common psychiatric diagnoses were major depressive disorder (n = 25; 100%) and post-traumatic stress disorder (n = 22; 88%). High psychiatric comorbidity rates were found in adolescents diagnosed with DD. A prevalent history of abuse and traumatic events was represented. Clinicians should be aware of the impacts of DD on adolescents' mental health. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

British-Pakistani women's perspectives of diabetes self-management: the role of identity.

Science.gov (United States)

Majeed-Ariss, Rabiya; Jackson, Cath; Knapp, Peter; Cheater, Francine M

2015-09-01

To explore the effects of type 2 diabetes on British-Pakistani women's identity and its relationship with self-management. Type 2 diabetes is more prevalent and has worse outcomes among some ethnic minority groups. This may be due to poorer self-management and an inadequate match of health services to patient needs. The influence that type 2 diabetes has on British-Pakistani women's identity and subsequent self-management has received limited attention. An explorative qualitative study. Face-to-face semi-structured English and Urdu language interviews were conducted with a purposively selected heterogeneous sample of 15 British-Pakistani women with type 2 diabetes. Transcripts were analysed thematically. Four themes emerged: Perceived change in self emphasised how British-Pakistani women underwent a conscious adaptation of identity following diagnosis; Familiarity with ill health reflected women's adjustment to their changed identity over time; Diagnosis improves social support enabled women to accept changes within themselves and Supporting family is a barrier to self-management demonstrated how family roles were an aspect of women's identities that was resilient to change. The over-arching theme Role re-alignment enables successful self-management encapsulated how self-management was a continuous process where achievements needed to be sustained. Inter-generational differences were also noted: first generation women talked about challenges associated with ageing and co-morbidities; second generation women talked about familial and work roles competing with self-management. The complex nature of British-Pakistani women's self-identification requires consideration when planning and delivering healthcare. Culturally competent practice should recognise how generational status influences self-identity and diabetes self-management in ethnically diverse women. Health professionals should remain mindful of effective self-management occurring alongside, and being

Identity Assemblages

DEFF Research Database (Denmark)

Horn, Line Helverskov

The study aims at exploring how identity is enacted within the context of a two-year programme in Service, Hospitality, and Tourism Management (SHTM). This research thus investigates how students and educators go about their daily lives in different educational contexts both on and off campus...... as a contribution to the body of literature of ANT-based studies. Second, it contributes to existing identity theories by exemplifying a socio-material approach to identity issues. Third, the study enables reflections upon how educational institutions as fundamentally identity-producing organisations acknowledge...

Civil Identity

DEFF Research Database (Denmark)

Petersen, Lars Axel

In this paper I will go through a catalogue of examples of contexts in which the term civil identity is currently used, ranging from the formal and technical process of linking a set of administrative and other events to an individual biological person by means of identity cards, fingerprints, iris...... of Israel to Luce Irigaray's Feminist agenda of elaborating gender specific civil identities. My intention is to investigate whether these different employments of 'civil identity' point towards a common, and fairly well defined object field asking questions of contemporary relevance to the philosophy...

On Fay identity

International Nuclear Information System (INIS)

Michev, Iordan P.

2006-01-01

In the first part of this paper we consider the transformation of the cubic identities for general Korteweg-de Vries (KdV) tau functions from [Mishev, J. Math. Phys. 40, 2419-2428 (1999)] to the specific identities for trigonometric KdV tau functions. Afterwards, we consider the Fay identity as a functional equation and provide a wide set of solutions of this equation. The main result of this paper is Theorem 3.4, where we generalize the identities from Mishev. An open problem is the transformation of the cubic identities from Mishev to the specific identities for elliptic KdV tau functions

Identity and identity conflict in the workplace

NARCIS (Netherlands)

K.E. Horton (Kate); P.S. Bayerl (Saskia); G. Belschak-Jacobs (Gabriele)

2014-01-01

textabstractAs individuals, we define ourselves according to various characteristics that include our values and beliefs. This gives us our identity. As organisations become increasingly complex, understanding the concept of identity conflict may mean the difference between success and failure.

'I am not a depressed person': how identity conflict affects help-seeking rates for major depressive disorder.

Science.gov (United States)

Farmer, Caroline; Farrand, Paul; O'Mahen, Heather

2012-10-02

There is a significant treatment gap for patients with depression. A third of sufferers never seek help, and the vast majority of those who do only do so after considerable delay. Little is understood regarding poor help-seeking rates amongst people with depression, with existing research mainly focussed on the impact of barriers to treatment. The current study explored psychological factors affecting help-seeking behaviour in clinically depressed individuals. Semi-structured interviews were conducted with 20 current or previously clinically depressed participants who either had or had not sought professional help. Thematic analysis was used to analyse results. The onset of depressive symptoms created conflict with participants' identity and personal goals. Delays in seeking help were primarily attributed to the desire to protect identity and goals from the threat of depressive symptoms. Participants used avoidance strategies to reduce the perceived threat of depressive symptoms on identity. These strategies interfered with help-seeking. Help-seeking was only undertaken once participants reached a point of acceptance and began to make concessions in their identity and goals, at which time they reduced their use of avoidance. Difficulties resolving conflict between identity and depressive symptoms may account for significant delays in seeking help for depression. The results have implications for predicting health behaviour and improving treatment uptake for depression, and may inform existing help-seeking models.

Mistaken identity: activating conservative political identities induces "conservative" financial decisions.

Science.gov (United States)

Morris, Michael W; Carranza, Erica; Fox, Craig R

2008-11-01

Four studies investigated whether activating a social identity can lead group members to choose options that are labeled in words associated with that identity. When political identities were made salient, Republicans (but not Democrats) became more likely to choose the gamble or investment option labeled "conservative." This shift did not occur in a condition in which the same options were unlabeled. Thus, the mechanism underlying the effect appears to be not activated identity-related values prioritizing low risk, but rather activated identity-related language (the group label "conservative"). Indeed, when political identities were salient, Republicans favored options labeled "conservative" regardless of whether the options were low or high risk. Finally, requiring participants to explain the label "conservative" before making their choice did not diminish the effect, which suggests that it does not merely reflect inattention to content or construct accessibility. We discuss the implications of these results for the literatures on identity, priming, choice, politics, and marketing.

Teacher educators: their identities, sub-identities and implications for professional development

NARCIS (Netherlands)

Swennen, J.M.H.; Jones, K.; Volman, M.L.L.

2010-01-01

In this article we address the question: 'What sub-identities of teacher educators emerge from the research literature about teacher educators and what are the implications of the sub-identities for the professional development of teacher educators?' Like other professional identities, the identity

Identity after Death

DEFF Research Database (Denmark)

Gerstrøm, Anna

2015-01-01

Purpose: The purpose of this paper is to explore how legacy organizational identity and death relate to each other and, thereby, contribute to closing the gap in knowledge on organizational identity constructions in times of death. Design/methodology/approach: The paper opted for an exploratory....../value: This paper addresses an apparent gap in the literature on identity and death; exploring identity narratives in a bankrupted bank, the paper considers constructions of legacy organizational identities in times of disruptive death....

Identity/Time

Directory of Open Access Journals (Sweden)

Nancy J. Knauer

2013-09-01

Full Text Available This paper engages the unspoken fourth dimension of intersectionality—time. Using the construction of lesbian, gay, bisexual, and transgender (LGBT identities as an example, it establishes that identity, as it is lived and experienced, is not only multivalent, but also historically contingent. It then raises a number of points regarding the temporal locality of identity—the influence of time on issues of identity and understanding, its implications for legal interventions, social movement building, and paradigms of progressive change. As the title suggests, the paper asks us to consider the frame of identity over time.

Vocational Identity and Ego Identity Status in Korean Nursing Students

Directory of Open Access Journals (Sweden)

Hyun-Young Koo, PhD, RN

2016-03-01

Conclusions: These findings show that nursing students in identity achievement status have secure and clear vocational identities. Further longitudinal and qualitative studies are needed to find out if identity formation among nursing students changes with age.

Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder.

Science.gov (United States)

Krause-Utz, Annegret; Frost, Rachel; Winter, Dorina; Elzinga, Bernet M

2017-01-01

Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia). While the precise neurobiological underpinnings of dissociation remain elusive, neuroimaging studies in disorders, characterized by high dissociation (e.g., depersonalization/derealization disorder (DDD), dissociative identity disorder (DID), dissociative subtype of posttraumatic stress disorder (D-PTSD)), have provided valuable insight into brain alterations possibly underlying dissociation. Neuroimaging studies in borderline personality disorder (BPD), investigating links between altered brain function/structure and dissociation, are still relatively rare. In this article, we provide an overview of neurobiological models of dissociation, primarily based on research in DDD, DID, and D-PTSD. Based on this background, we review recent neuroimaging studies on associations between dissociation and altered brain function and structure in BPD. These studies are discussed in the context of earlier findings regarding methodological differences and limitations and concerning possible implications for future research and the clinical setting.

Ternutator identities

International Nuclear Information System (INIS)

Devchand, Chandrashekar; Fairlie, David; Nuyts, Jean; Weingart, Gregor

2009-01-01

The ternary commutator or ternutator, defined as the alternating sum of the product of three operators, has recently drawn much attention as an interesting structure generalizing the commutator. The ternutator satisfies cubic identities analogous to the quadratic Jacobi identity for the commutator. We present various forms of these identities and discuss the possibility of using them to define ternary algebras.

Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour.

Science.gov (United States)

Reitz, Sarah; Kluetsch, Rosemarie; Niedtfeld, Inga; Knorz, Teresa; Lis, Stefanie; Paret, Christian; Kirsch, Peter; Meyer-Lindenberg, Andreas; Treede, Rolf-Detlef; Baumgärtner, Ulf; Bohus, Martin; Schmahl, Christian

2015-08-01

Patients with borderline personality disorder frequently show non-suicidal self-injury (NSSI). In these patients, NSSI often serves to reduce high levels of stress. Investigation of neurobiological mechanisms of NSSI in borderline personality disorder. In total, 21 women with borderline personality disorder and 17 healthy controls underwent a stress induction, followed by either an incision into the forearm or a sham treatment. Afterwards participants underwent resting-state functional magnetic resonance imaging while aversive tension, heart rate and heart rate variability were assessed. We found a significant influence of incision on subjective and objective stress levels with a stronger decrease of aversive tension in the borderline personality disorder group following incision than sham. Amygdala activity decreased more and functional connectivity with superior frontal gyrus normalised after incision in the borderline personality disorder group. Decreased stress levels and amygdala activity after incision support the assumption of an influence of NSSI on emotion regulation in individuals with borderline personality disorder and aids in understanding why these patients use self-inflicted pain to reduce inner tension. © The Royal College of Psychiatrists 2015.

[Adolescents with gender identity disorder: reconsideration of the age limits for endocrine treatment and surgery].

Science.gov (United States)

Nakatsuka, Mikiya

2012-01-01

The third versions of the guideline for treatment of people with gender identity disorder (GID) of the Japanese Society of Psychiatry and Neurology does not include puberty-delaying hormone therapy. It is recommended that feminizing/masculinizing hormone therapy and genital surgery should not be carried out until 18 year old and 20 year old, respectively. On the other hand, the sixth (2001) and the seventh (2011) versions of the standards of care for the health of transsexual, transgender, and gender nonconforming people of World Professional Association for Transgender Health (WPATH) recommend that transsexual adolescents (Tanner stage 2, [mainly 12-13 years of age]) are treated by the endocrinologists to suppress puberty with gonadotropin-releasing hormone (GnRH) agonists until age 16 years old, after which cross-sex hormones may be given. A questionnairing on 181 people with GID diagnosed in the Okayama University Hospital (Japan) showed that female to male (FTM) transsexuals hoped to begin masculinizing hormone therapy at age of 15.6 +/- 4.0 (mean +/- S.D.) whereas male to female (MTF) transsexuals hoped to begin feminizing hormone therapy as early as age 12.5 +/- 4.0, before presenting secondary sex characters. After confirmation of strong and persistent cross-gender identification, adolescents with GID should be treated with cross-gender hormone or puberty-delaying hormone to prevent developing undesired sex characters. These treatments may prevent transsexual adolescents from attempting suicide, being depressive, and refusing to attend school. Subsequent early breast and genital surgery may help being employed in desired sexuality.

Acute myocardial infarctation in patients with critical ischemia underwent lower limb revascularization

Directory of Open Access Journals (Sweden)

Esdras Marques Lins

2013-12-01

Full Text Available BACKGROUND: Atherosclerosis is the main cause of peripheral artery occlusive disease (PAOD of the lower limbs. Patients with PAOD often also have obstructive atherosclerosis in other arterial sites, mainly the coronary arteries. This means that patients who undergo infrainguinal bypass to treat critical ischemia have a higher risk of AMI. There are, however, few reports in the literature that have assessed this risk properly. OBJECTIVE: The aim of this study was to determine the incidence of acute myocardial infarction in patients who underwent infrainguinal bypass to treat critical ischemia of the lower limbs caused by PAOD. MATERIAL AND METHODS: A total of 64 patients who underwent 82 infrainguinal bypass operations, from February 2011 to July 2012 were studied. All patients had electrocardiograms and troponin I blood assays during the postoperative period (within 72 hours. RESULTS: There were abnormal ECG findings and elevated blood troponin I levels suggestive of AMI in five (6% of the 82 operations performed. All five had conventional surgery. The incidence of AMI as a proportion of the 52 conventional surgery cases was 9.6%. Two patients died. CONCLUSION: There was a 6% AMI incidence among patients who underwent infrainguinal bypass due to PAOD. Considering only cases operated using conventional surgery, the incidence of AMI was 9.6%.

[Prevalence of sleep-related breathing disorders of inpatients with psychiatric disorders].

Science.gov (United States)

Behr, M; Acker, J; Cohrs, S; Deuschle, M; Danker-Hopfe, H; Göder, R; Norra, C; Richter, K; Riemann, D; Schilling, C; Weeß, H-G; Wetter, T C; Wollenburg, L M; Pollmächer, T

2018-06-06

Sleep-related breathing disorders seriously impair well-being and increase the risk for relevant somatic and psychiatric disorders. Moreover, risk factors for sleep-related breathing disorders are highly prevalent in psychiatric patients. The aim of this study was for the first time in Germany to study the prevalence of obstructive sleep apnea syndrome (OSAS) as the most common form of sleep-related breathing disorder in patients with psychiatric disorders. In 10 psychiatric hospitals in Germany and 1 hospital in Switzerland, a total of 249 inpatients underwent an 8‑channel sleep polygraphy to investigate the prevalence of sleep apnea in this group of patients. With a conspicuous screening result of 23.7% of the subjects, a high prevalence of sleep-related breathing disorders was found to occur among this group of patients. Male gender, higher age and high body mass index (BMI) were identified as positive risk factors for the detection of OSAS. The high prevalence indicates that sleep apnea is a common sleep disorder among psychiatric patients. Although OSAS can lead to substantial disorders of the mental state and when untreated is accompanied by serious somatic health problems, screening procedures are not part of the routine work-up in psychiatric hospitals; therefore, sleep apnea is presumably underdiagnosed in psychiatric patients. In view of the results of this and previous studies, this topic complex should be the subject of further research studies.

Ethnic Identity in Everyday Life: The Influence of Identity Development Status

Science.gov (United States)

Yip, Tiffany

2013-01-01

The current study explores the intersection of ethnic identity development and significance in a sample of 354 diverse adolescents (mean age 14). Adolescents completed surveys 5 times a day for 1 week. Cluster analyses revealed 4 identity clusters: diffused, foreclosed, moratorium, achieved. Achieved adolescents reported the highest levels of identity salience across situations, followed by moratorium adolescents. Achieved and moratorium adolescents also reported a positive association between identity salience and private regard. For foreclosed and achieved adolescents reporting low levels of centrality, identity salience was associated with lower private regard. For foreclosed and achieved adolescents reporting high levels of centrality, identity salience was associated with higher private regard. PMID:23581701

Experiencing with Identity

DEFF Research Database (Denmark)

Pors, Justine Grønbæk

2012-01-01

This article studies how a political organization begins to experiment with its identity. By use of an empirical case of the Danish Ministry of Education, I examine how a political organization supplements its identity of a legislating power with identities of a supervisor, beacon and facilitator...... of evaluation in public schools. Out of a paralysis emerge new innovative strategies of governing, aimed at the schools’ self-governing capacity. The identity of the political system thus emerges as oscillations between different roles of a legislating power and a supervising coach. The case study suggests...... that a society of experimentalism is emerging. Thus, the relevant object of study is no longer organizational identity, but the experiments with different identities that modern organizations are performing....

Antinuclear, Cytoskeletal, Antineuronal Antibodies in the Serum Samples of Children with Tic Disorders and Obsessive Compulsive Disorders

Directory of Open Access Journals (Sweden)

Işık Görker

2011-11-01

Full Text Available streptococcus infections in the development of tic and obsessive compulsive disorders (OCD is controversial. The autoimmune hypothesis states that during infection, formation of autoantibodies leads to an autoimmune disorder, which in turn results in movement disorders, tic disorders and/or OCD. In order to test this hypothesis, we assayed these antibodies in children and adolescents diagnosed with tic disorders and/or OCD.Material and Methods: Children and adolescents who were diagnosed with either tic disorders or OCD according to DSM-IV criteria (n=28, were compared with healthy controls (n=15 having similar age and gender characteristics. Regardless of a streptococcus infection history, serum samples of all patients and controls underwent antinuclear, cytoskeletal, and antineuronal antibody assay using indirect immunofluorescence.Results: The rates of antinuclear antibody positivity were 21% and 20% in the patient and control groups respectively (p>0.05. Antineuronal antibody was positive in 2 (7% of 28 patients versus in 1 (6% of 15 controls (p>0.05.Conclusion: These results suggest that such antibodies may not be involved in the pathogenesis of tic disorders/OCD.

A Case of Pain, Factitious Disorder and Boundary Violations

Directory of Open Access Journals (Sweden)

Isabelle Cote

2001-01-01

Full Text Available Although health professionals are usually familiar with factitious disorders, evaluating such cases may be complicated, particularly in the legal arena. This article describes a patient who presented with pain complaints to numerous doctors. Eventually, a malpractice suit was brought against one of the patient's physicians who had diagnosed her condition as multiple personality disorder (dissociative identity disorder. Factitious disorder and the doctor's prescription of pain medications were issues raised during the trial. In view of the issue of harm, physicians' responsibilities and limitations during ongoing medical care are addressed in this case report.

Autobiographical Memory in Borderline Personality Disorder – A Review

DEFF Research Database (Denmark)

Beck, Morten; Elklit, Ask; Simonsen, Erik

2015-01-01

Borderline personality disorder is a severe psychiatric illness. A key feature of the disorder is a disorganized sense of self often referred to as identity diffusion. Autobiographical memory is memory for personal life events. One of the main functions of these memories is to enable us...... to understand who we are by connecting past, present and future experiences. It seems that autobiographical memory is in some way disrupted in individuals with borderline personality disorder. A systematic review is conducted looking at studies that focus on the potential connections. We find that although......, autobiographical memory and borderline personality disorder....

Identity Work and Emotions

DEFF Research Database (Denmark)

Winkler, Ingo

2018-01-01

This paper reviews the empirical literature on identity work and identifies two distinct approaches to incorporating emotion. The majority of empirical studies use emotion to describe the experiences of identity work. In doing so, the authors (a) mention the emotions that people feel in situations...... that trigger identity work, (b) illustrate identity work as an emotional endeavour, and (c) describe the emotional impact of successful and unsuccessful identity work. There is also an emerging literature that examines the mutual constitution of emotions and identity work. These authors address emotional...... labour, affective social identification, emotional attachment and detachment, and humour when studying identity work. This paper suggests that, to understand better the relation between emotions and identity work, future research should examine the role of emotions in problematizing identity...

Spacing Identity

DEFF Research Database (Denmark)

Stang Våland, Marianne; Georg, Susse

2018-01-01

In this paper, we analyze how architectural design, and the spatial and material changes this involves, contributes to the continuous shaping of identities in an organization. Based upon a case study of organizational and architectural change in a municipal administration at a time of major public...... sector reforms, we examine how design interventions were used to (re)form work and professional relationships. The paper examines how engagements with spatial arrangements and material artifacts affected people’s sense of both occupational and organizational identity. Taking a relational approach...... to sociomateriality, the paper contributes to the further theorizing of space in organization studies by proposing the concept of spacing identity to capture the fluidity of identity performance....

Identity Presentation: The Construction of Identity in Asynchronous Discussion

Directory of Open Access Journals (Sweden)

Brian Morgan

2008-08-01

Full Text Available This study examines the use of e-mail as a tool for long term discussion between teachers and grade six students. E-mail messages between grade six students and teachers were collected over the course of one academic year. Methods of conversation analysis within a framework of social practice are used to examine the data. While identity is more readily constructed and more fully developed in contexts which allow for physical embodiment such as face-to-face discussion, this analysis found that identity can be constructed in a context that does not provide for the physical embodiment of identity: Identity was constructed using the social, cultural, and technological tools provided and supported by e-mail to develop social practices germane to the e-mail discussion. This study has implications for further understanding the relation between identity, goals, constraints and affordances, and the collaborative creation of social practices in asynchronous computer mediated communication. URN: urn:nbn:de:0114-fqs0803185

Identity Styles and Religiosity: Examining the Role of Identity Commitment

Science.gov (United States)

Grajales, Tevni E.; Sommers, Brittany

2016-01-01

This study observed the role of identity styles, identity commitment, and identity statuses in predicting religiosity in a sample of undergraduate students attending a Seventh-day Adventist university (N = 138). Two structural models were evaluated via path analysis. Results revealed two strong models for the prediction of religiosity. Identity…

Political, religious and occupational identities in context: placing identity status paradigm in context.

Science.gov (United States)

Solomontos-Kountouri, Olga; Hurry, Jane

2008-04-01

This study critically contrasts global identity with domain-specific identities (political, religious and occupational) and considers context and gender as integral parts of identity. In a cross-sectional survey, 1038 Greek Cypriot adolescents (449 boys and 589 girls, mean age 16.8) from the three different types of secondary schools (state, state technical and private) and from different SES completed part of the Extended Objective Measure of Ego Identity Status-2 (EOMEIS-2). The macro-context of Greek Cypriot society is used to understand the role of context in adolescents' identities. Results showed that Greek Cypriot young people were not in the same statuses across their global, political, religious and occupational identities. This heterogeneity in the status of global identity and of each identity domain is partially explained by differences in gender, type of school and SES (socio-economic status). The fact that identity status is found to be reactive to context suggests that developmental stage models of identity status should place greater emphasis on context.

[Iron Man: Between Confusion of Identity and Addiction to Technology].

Science.gov (United States)

Chapellon, Sébastien; Houssier, Florian

The fascination surrounding a successful artwork is linked to the fact it faces the viewer to unknown aspects of his/her own psychic life. The same applies to the comics Iron Man. Behind the armour is hiding a man caught up in the traumatic incidences of life. The hero demonstrates a psychic weakness which, despite being deep, is, however, showing universal aspects.The analysis of his misfortunes reveals a narcissistic disorder. The article intends to set out the identity confusion the Marvel's protagonist is trapped in while highlighting the addictive troublesome linking him to his high-tech armour. This article also seeks to attest the fact the symbiosis between Tony Stark and Iron Man is anticipating the evolution of our behaviour with regard to new technologies.To this end, the authors are recalling the episodes of the series. Through the analysis of the confrontational dialogue the hero is maintaining with his iron armour, they explore how the internal experiment related to the sense of identity disorder is figured out. Thus, going through the key moments of the saga, the authors raise the ambiguity of his hero. The metapsychological analysis of the actions undertaken by Iron Man reflects a little-known facet of his personality, revealing a character more tormented than he really looks. However, the point is not to "treat" a fictional man, but to observe how he can help us to understand the internal behaviour of our patients, and also our own.The Faustian drama this comic leads to is hence understood as a living testimony of our own psychic conflicts. Furthermore, the analysis gives rise to a questioning as to the risk of identity confusion the technological progress can create at a time when the Human is more and more depending on the machines he creates himself.

Discourse, Power Interplays and "Disordered Identities": An Intersectional Framework for Analysis and Policy Development

Science.gov (United States)

Liasidou, Anastasia

2016-01-01

While acknowledging the discursive constitution of student identities through the interplay of unequal power relations and discriminatory processes, the article discusses the ways in which social, emotional and behaviour difficulties (SEBD) are "produced" and "managed" within current schooling. SEBD are routinely framed in…

Identities as organizational practices

DEFF Research Database (Denmark)

Oshima, Sae; Asmuß, Birte

Identity has been widely acknowledged as playing a central role in various organizational processes, yet there is still a need to better understand the dynamics and functions of identity work in modern organizations. The present paper is centered within this concern, and examines identity......) reveal the intersubjective, multimodal and embodied nature of identity work; 2) demonstrate identity work as organizational practices, used in order to accomplish specific actions; and 3) pose a question on the view on identity as a layered/leveled phenomenon....

Self-disorders and the Schizophrenia Spectrum

DEFF Research Database (Denmark)

Nordgaard, Julie; Parnas, Josef

2014-01-01

INTRODUCTION: Self-disorders (SD) have been described as a core feature of schizophrenia both in classical and recent psychopathological literature. However, the specificity of SD for the schizophrenia spectrum disorders has never been demonstrated in a diagnostically heterogeneous sample, nor has...... the concurrent validity of SD been examined. AIM: (1) To examine the specificity of Examination of Anomalous Self-Experiences (EASE) measured SD to the schizophrenia spectrum disorder in first contact inpatients, (2) to explore the internal consistency and factorial structure of the EASE, (3) to assess...... the concurrent validity of SD by exploring correlations between SD and the canonical psychopathological dimensions of schizophrenia, (4) to explore relations of SD to intelligence, sociodemographic, and extrinsic illness characteristics. METHODS: A total of 100 consecutive first admission patients underwent...

Dissociative trance disorder: clinical and Rorschach findings in ten persons reporting demon possession and treated by exorcism.

Science.gov (United States)

Ferracuti, S; Sacco, R; Lazzari, R

1996-06-01

Although dissociative trance disorders, especially possession disorder, are probably more common than is usually though, precise clinical data are lacking. Ten persons undergoing exorcisms for devil trance possession state were studied with the Dissociative Disorders Diagnostic Schedule and the Rorschach test. These persons had many traits in common with dissociative identity disorder patients. They were overwhelmed by paranormal experiences. Despite claiming possession by a demon, most of them managed to maintain normal social functioning. Rorschach findings showed that these persons had a complex personality organization: Some of them displayed a tendency to oversimplify stimulus perception whereas others seemed more committed to psychological complexity. Most had severe impairment of reality testing, and 6 of the participants had an extratensive coping stile. In this group of persons reporting demon possession, dissociative trance disorder seems to be a distinct clinical manifestation of a dissociative continuum, sharing some features with dissociative identity disorder.

Mobile Identity Management

NARCIS (Netherlands)

Hoepman, J.J.

2011-01-01

Identity management consists of the processes and all underlying technologies for the creation, management, and usage of digital identities. Business rely on identity management systems to simplify the management of access rights to their systems and services for both their employees and their

A developmental, biopsychosocial model for the treatment of children with gender identity disorder.

Science.gov (United States)

Zucker, Kenneth J; Wood, Hayley; Singh, Devita; Bradley, Susan J

2012-01-01

This article provides a summary of the therapeutic model and approach used in the Gender Identity Service at the Centre for Addiction and Mental Health in Toronto. The authors describe their assessment protocol, describe their current multifactorial case formulation model, including a strong emphasis on developmental factors, and provide clinical examples of how the model is used in the treatment.

A parent-report gender identity questionnaire for children.

Science.gov (United States)

Johnson, Laurel L; Bradley, Susan J; Birkenfeld-Adams, Andrea S; Kuksis, Myra A Radzins; Maing, Dianne M; Mitchell, Janet N; Zucker, Kenneth J

2004-04-01

This paper reports on the psychometric properties of a 16-item parent-report Gender Identity Questionnaire, originally developed by P. H. Elizabeth and R. Green (1984), to aid in the assessment of children with potential problems in their gender identity development. The questionnaire, which covered aspects of the core phenomenology of gender identity disorder (GID), was completed by parents of gender-referred children (N = 325) and controls (siblings, clinic-referred, and nonreferred; N = 504), who ranged in age from 2.5-12 years (mean age, 7.6 years). Factor-analysis indicated that a one-factor solution, containing 14 of the 16 items with factor loadings > or =.30, best fit the data, accounting for 43.7% of the variance. The gender-referred children had a significantly more deviant total score than did the controls, with a large effect size of 3.70. The GIQ total score had negligible age effects, indicating that the questionnaire has utility for assessing change over time. The gender-referred children who met the complete DSM criteria for GID had a significantly more deviant total score than did the children who were subthreshold for GID, although the latter group had a mean score that was closer to the threshold cases than to the controls. With a specificity rate set at 95% for the controls, the sensitivity rate for the probands was 86.8%. It is concluded that this parent-report gender identity questionnaire has excellent psychometric properties and can serve as a useful screening device for front-line clinicians, for whom more extensive, expensive, and time-consuming assessment procedures may be precluded.

Impulse control disorder and rapid eye movement sleep behavior disorder in Parkinson's disease.

Science.gov (United States)

Bayard, Sophie; Dauvilliers, Yves; Yu, Huan; Croisier-Langenier, Muriel; Rossignol, Alexia; Charif, Mahmoud; Geny, Christian; Carlander, Bertrand; Cochen De Cock, Valérie

2014-12-01

The relationship between ICD and RBD is still not yet understood and the results from the current literature are contradictory in PD. We aimed to explore the association between rapid eye movement (REM) sleep behavior disorder (RBD) and impulse control disorder in Parkinson's disease. Ninety-eight non-demented patients with Parkinson's disease underwent one night of video-polysomnography recording. The diagnosis of RBD was established according to clinical and polysomnographic criteria. Impulse control disorders were determined by a gold standard, semi-structured diagnostic interview. Half of the patients (n = 49) reported clinical history of RBD while polysomnographic diagnosis of RBD was confirmed in 31.6% of the patients (n = 31). At least one impulse control disorder was identified in 21.4% of patients, 22.6% with RBD and 20.9% without. Logistic regression controlling for potential confounders indicated that both clinical RBD (OR = 0.34, 95% CI = 0.07-1.48, P = 0.15) and polysomnographic confirmed RBD diagnoses (OR = 0.1.28, 95% CI = 0.31-5.33, P = 0.34) were not associated with impulse control disorder. In Parkinson's disease, REM Sleep Behavior Disorder is not associated with impulse control disorder. The results of our study do not support the notion that PSG-confirmed RBD and ICD share a common pathophysiology. Copyright © 2014 Elsevier Ltd. All rights reserved.

Identity Management

CERN Document Server

Pace, A

2008-01-01

This paper introduces identity management concepts and discusses various issues associated with its implementation. It will try to highlight technical, legal, and social aspects that must been foreseen when defining the numerous processes that an identity management infrastructure must support. Grid interoperability as well as cross platform interoperability is addressed on the technical aspect, followed by a short discussion on social consequences on user’s privacy when completed traceability is enforced and some examples on how identity management has been implemented at CERN

Identity management

International Nuclear Information System (INIS)

Pace, A

2008-01-01