Editing Dissociative identity disorder (section)

==Controversy and criticism of validity==
DID is among the most controversial of the dissociative disorders and among the most controversial disorders found in the DSM-5-TR.<ref name=Stern>{{cite book |vauthors=Stern TA, Fava M, MD, Wilens TE, MD, Rosenbaum JF |year=2015 |title=Massachusetts General Hospital Comprehensive Clinical Psychiatry |publisher=[[Elsevier Health Sciences]] |isbn=978-0-323-29507-9 |pages=395–397 |url=https://books.google.com/books?id=deR1BwAAQBAJ&pg=PA395}}</ref><ref name=Hersen2012/><ref name="Blihar"/> The primary dispute is between those who believe DID is caused by traumatic stresses that split the mind into [[Multiplicity (psychology)|multiple identities]], each with a separate set of memories,<ref name= Howell/><ref name=Kihlstrom/> and those who believe that the symptoms of DID are produced [[Iatrogenesis#Psychology|artificially]] by certain psychotherapeutic practices or patients playing a role they believe appropriate for a person with DID.<ref name=Blackwell/><ref name="pmid15503730"/><ref name="MacDonald" /><ref name="Weiten">{{cite book |last=Weiten |first=W |title=Psychology: Themes and Variations |publisher=[[Cengage Learning]] |year=2010 |isbn=978-0-495-81310-1 |edition=8 |pages=[https://books.google.com/books?id=Wnr7vEjB7NAC&pg=PA461 461]}}</ref><ref name=Cardena2>{{cite book |editor1=Hersen M |editor2=Turner SM |editor3=Beidel DC |vauthors=Cardena E, Gleaves DH |title=Adult Psychopathology and Diagnosis |pages=[https://books.google.com/books?id=YBSqjV6wFQQC&pg=PA473 473–503] |year=2007 |publisher=[[John Wiley & Sons]] |isbn=978-0-471-74584-6 |chapter=Dissociative Disorders}}</ref> The debate between the two positions is characterized by intense disagreement.<ref name=Rein2008/><ref name=Blackwell/><ref name="pmid15560314"/><ref name="pmid15503730"/><ref name =Weiten/><ref name=Cardena2/> Research has been characterized by poor [[Scientific method|methodology]].<ref name="Howell">{{cite book |last=Howell |first=Elizabeth |title=Knowing, not-knowing and sort-of-knowing: psychoanalysis and the experience of uncertainty |publisher=Karnac Books |year=2010 |isbn=978-1-85575-657-1 |editor=Petrucelli E |pages=[https://books.google.com/books?id=HRqjEBQJ6uYC&pg=PA83 83–98] |chapter=Dissociation and dissociative disorders: commentary and context |doi=10.4324/9780429476457-6}}</ref> Psychiatrist Joel Paris asserts that the idea that a personality is capable of splitting into independent alters is an unproven assertion at odds with research in [[cognitive psychology]],<ref name = Paris2012/> while David Gleaves argues that recognition of DID was in fact prompted by developments in that field, including theories of [[Parallel processing (psychology)|parallel-distributed processing]].<ref>{{cite journal|title =The Sociocognitive Model of Dissociative Identity Disorder: A Reexamination of the Evidence|last = Gleaves|first = David H. |journal = Psychological Bulletin |year = 1996|volume=120|number = 1|pages = 42-59|doi=10.1037/0033-2909.120.1.42 }}</ref>

Some people, such as Russell A. Powell and Travis L. Gee, believe that DID is caused by health care, i.e. symptoms of DID are created by therapists themselves via hypnosis. This implies that those with DID are especially susceptible to manipulation by hypnosis and suggestion.<ref>{{Cite journal |last1=Powell |first1=Russell A |last2=Gee |first2=Travis L |date=November 1999 |title=The Effects of Hypnosis on Dissociative Identity Disorder: A Reexamination of the Evidence |url=http://dx.doi.org/10.1177/070674379904400908 |journal=The Canadian Journal of Psychiatry |volume=44 |issue=9 |pages=914–916 |doi=10.1177/070674379904400908 |pmid=10584162 |s2cid=13018682 |issn=0706-7437}}</ref> The iatrogenic model also sometimes states that treatment for DID is harmful. According to Brand, Loewenstein, and Spiegel, "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". Their claim is evidenced by the fact that only 5%–10% of people receiving treatment initially worsen in their symptoms.<ref name=Brand2014 />

Psychiatrists August Piper and Harold Merskey have challenged the trauma hypothesis, arguing that [[correlation does not imply causation]]—that people with DID report childhood trauma does not mean trauma causes DID—and point to the rarity of the diagnosis before 1980 as well as a failure to find DID as an outcome in [[longitudinal study|longitudinal studies]] of traumatized children. They assert that DID cannot be accurately diagnosed because of vague and unclear diagnostic criteria in the DSM and undefined concepts such as "personality state" and "identities", and question the evidence for childhood abuse beyond self-reports, the lack of a defined threshold of abuse sufficient to induce DID, and the extremely small number of cases of children diagnosed with DID despite an average age of appearance of the first alter of three years.<ref name="pmid15560314"/> Psychiatrist Colin Ross disagrees with Piper and Merskey's conclusion that DID cannot be accurately diagnosed, pointing to internal consistency between different structured dissociative disorder interviews (including the [[Dissociative Experiences Scale]], Dissociative Disorders Interview Schedule, and Structured Clinical Interview for Dissociative Disorders)<ref name=Kihlstrom/> in the internal validity range of widely accepted mental illnesses such as schizophrenia and [[major depressive disorder]]. In his opinion, Piper and Merskey set the standard of proof higher than it is for other diagnoses. He also asserts that Piper and Merskey have [[cherry picking (fallacy)|cherry-picked]] data and not incorporated all relevant scientific literature, such as independent corroborating evidence of trauma.<ref name=Ross2009>{{cite journal | author = Ross CA | title = Errors of Logic and Scholarship Concerning Dissociative Identity Disorder | journal = Journal of Child Sexual Abuse | volume = 18 | issue = 2 | pages = 221–231 | year = 2009 | pmid = 19306208 | doi = 10.1080/10538710902743982 | s2cid = 41312090 }}</ref>