Editing Dissociative identity disorder (section)

===Sociogenic model===
Symptoms of dissociative identity disorder may be created by therapists using [[recovered-memory therapy|techniques to "recover" memories]] (such as the use of [[hypnosis]] to "access" alter identities, facilitate [[Age regression in therapy|age regression]] or retrieve memories) on suggestible individuals.<ref name="pmid15503730" /><ref name="pmid15560314"/><ref name =Cardena/><ref name = Boysen/><ref name="Blackwell">{{cite book |last=Rubin |first=EH |url=https://books.google.com/books?id=uX4ZwtDKNqMC&pg=PA280 |title=Adult psychiatry: Blackwell's neurology and psychiatry access series |publisher=[[John Wiley & Sons]] |year=2005 |isbn=978-1-4051-1769-2 |editor=Rubin EH |edition=2nd |page=280 |editor2=Zorumski CF}}</ref> Referred to as the non-trauma-related model, or the sociocognitive model or fantasy model, it proposes that dissociative identity disorder is due to a person consciously or unconsciously behaving in certain ways promoted by cultural stereotypes,<ref name = Boysen/> with unwitting therapists providing cues through improper therapeutic techniques. This model posits that behavior is enhanced by media portrayals of dissociative identity disorder.<ref name = Lynn2012/>

Proponents of the non-trauma-related model note that the dissociative symptoms are rarely present before intensive therapy by specialists in the treatment of dissociative identity disorder who, through the process of eliciting, conversing with, and identifying alters, shape or possibly create the diagnosis.<ref>{{cite book |last1=Mitra |first1=Paroma |last2=Jain |first2=Ankit |title=StatPearls |date=2023 |publisher=StatPearls Publishing |url=https://www.ncbi.nlm.nih.gov/books/NBK568768/ |access-date=15 May 2023 |chapter=Dissociative Identity Disorder|pmid=33760527 }}</ref> While proponents note that dissociative identity disorder is accompanied by genuine suffering and the distressing symptoms, and can be diagnosed reliably using the DSM criteria, they are skeptical of the trauma-related etiology suggested by proponents of the trauma-related model.<ref name = McNally2005/> Proponents of non-trauma-related dissociative identity disorder are concerned about the possibility of hypnotizability, suggestibility, frequent fantasization and mental absorption predisposing individuals to dissociation.<ref name="MacDonald">{{cite journal |last1=MacDonald |first1=Kai |title=Dissociative disorders unclear? Think 'rainbows from pain blows' |journal=Current Psychiatry |date=1 May 2008 |volume=7 |issue=5 |pages=73–85 |id={{Gale|A179269544}} |url=https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/0705CP_Article3.pdf}}</ref> They note that a small subset of doctors are responsible for diagnosing the majority of individuals with dissociative identity disorder.<ref name="Blackwell neurology">{{cite book |title=Adult psychiatry: Blackwell's neurology and psychiatry access series |last=Rubin |first=EH |editor=Rubin EH |editor2=Zorumski CF |edition=2nd |publisher=[[John Wiley & Sons]] |year=2005 |isbn=978-1-4051-1769-2 |page=280 |url=https://books.google.com/books?id=uX4ZwtDKNqMC&pg=PA280}}</ref><ref name="pmid15560314"/><ref name = Paris2012/>

Psychologist [[Nicholas Spanos]] and others have suggested that, besides cases caused by therapy, dissociative identity disorder might result from [[role-playing]]. However, others disagree, arguing that there is no strong incentive for people to fabricate or maintain separate identities. They also cite reported histories of abuse as evidence.<ref>{{cite book |title=Psychology: Themes and Variations |last=Weiten |first=W |edition=8 |year=2010 |publisher=[[Cengage Learning]] |isbn=978-0-495-81310-1 |pages=[https://books.google.com/books?id=Wnr7vEjB7NAC&pg=PA461 461]}}</ref> Other arguments that therapy can cause dissociative identity disorder include the lack of children diagnosed with DID, the sudden spike in [[incidence (epidemiology)|rates of diagnosis]] after 1980 (although dissociative identity disorder was not a diagnosis until DSM-IV, published in 1994), the absence of evidence of increased rates of child abuse, the appearance of the disorder almost exclusively in individuals undergoing psychotherapy, particularly involving [[hypnosis]], the presences of bizarre alternate identities (such as those claiming to be animals or mythological creatures) and an increase in the number of alternate identities over time<ref name="Lynn2012" /><ref name="pmid15560314" /> (as well as an initial increase in their number as psychotherapy begins in DID-oriented therapy<ref name="Lynn2012" />). These various cultural and therapeutic causes occur within a context of pre-existing psychopathology, notably [[borderline personality disorder]], which is commonly comorbid with dissociative identity disorder.<ref name="Lynn2012" /> In addition, presentations can vary across cultures, such as [[India]]n patients who only switch alters after a period of sleep – which is commonly how dissociative identity disorder is presented by the media within that country.<ref name="Lynn2012" />

Proponents of non-trauma-related dissociative identity disorder state that the disorder is strongly linked to (possibly suggestive) psychotherapy, often involving [[Repressed memory|recovered memories]] (memories that the person previously had amnesia for) or [[False memory|false memories]], and that such therapy could cause additional identities. Such memories could be used to make an allegation of [[child sexual abuse]]. There is little agreement between those who see therapy as a cause and trauma as a cause.<ref name="Rein2008">{{cite journal|author=Reinders AA |title=Cross-examining dissociative identity disorder: Neuroimaging and etiology on trial |journal=Neurocase |volume=14 |issue=1 |pages=44–53 |year=2008 |pmid=18569730 |doi=10.1080/13554790801992768 |s2cid=38251430}}</ref> Supporters of therapy as a cause of dissociative identity disorder suggest that a small number of clinicians diagnosing a disproportionate number of cases would provide evidence for their position<ref name="Boysen" /> though it has also been claimed that higher rates of diagnosis in specific countries like the United States may be due to greater awareness of DID. Lower rates in other countries may be due to artificially low recognition of the diagnosis.<ref name="Cardena" /> However, false memory syndrome ''per se'' is not regarded by mental health experts as a valid diagnosis,<ref>{{cite book|last=Rix |first=Rebecca |title=Sexual abuse litigation: a practical resource for attorneys, clinicians, and advocates |publisher=Routledge |year=2000 |page=33 |isbn=978-0-7890-1174-9}}</ref> and has been described as "a non-psychological term originated by a private foundation whose stated purpose is to support accused parents,"<ref name="Carstensen1993">{{cite journal|last1=Carstensen |first1=L. |last2=Gabrieli |first2=J. |last3=Shepard |first3=R. |last4=Levenson |first4=R. |last5=Mason |first5=M. |last6=Goodman |first6=G. |last7=Bootzin |first7=R. |last8=Ceci |first8=S. |last9=Bronfrenbrenner |first9=U. |last10=Edelstein |first10=B. |last11=Schober |first11=M. |last12=Bruck |first12=M. |last13=Keane |first13=T. |last14=Zimering |first14=R. |last15=Oltmanns |first15=T. |last16=Gotlib |first16=I. |last17=Ekman |first17=P. |date=March 1993 |title=Repressed objectivity |journal=APS Observer |volume=6 |pages=23 |url=https://blogs.brown.edu/recoveredmemory/files/2010/06/APS_Observer_letter.pdf}}</ref> and critics argue that the concept has no empirical support, and further describe the [[False Memory Syndrome Foundation]] as an advocacy group that has distorted and misrepresented memory research.<ref name="Dallam">{{cite journal |last1=Dallam |first1=Stephanie J. |title=Crisis or Creation? A Systematic Examination of False Memory Syndrome |journal=Journal of Child Sexual Abuse |date=11 March 2001 |volume=9 |issue=3–4 |pages=9–36 |doi=10.1300/J070v09n03_02 |pmid=17521989 |s2cid=26047059}}</ref><ref name="olio">{{cite book|editor=Cosgrove L |editor2=Caplan PJ |last=Olio |first=KA |title=Bias in psychiatric diagnosis |publisher=Jason Aronson |location=Northvale, N.J |year=2004 |pages=[https://books.google.com/books?id=6XPLguPHzHoC&pg=PA163 163–168] |isbn=978-0-7657-0001-8 |chapter=The Truth About 'False Memory Syndrome'}}</ref>

A review of recent research into DID found not one empirical study into the sociocognitive model in the 2011-2021 period, identifying the model as "a source of unresolved criticism of the trauma model", not an empirical hypothesis in its own right. Some major skeptics of trauma-related DID have in recent years abandoned single-cause models of the disorder, arguing for an end to the controversy as no such model can provide a "complete or fully satisfactory account" of DID.<ref name=boysen2024/> As part of their "trans-theoretical" model Lynn et al. suggested that trauma may be more important than sociocognitive factors in clinical cases.<ref name=lynn2022>{{cite journal|last1=Lynn|first1=Steven Jay|last2 = Polizzi|first2 = Craig| last3 = Merckelbach| first3 = Harald| last4=Chiu |first4= Chui-De|last5=Maxwell|first5=Reed|last6 = van Heugten| first6=Delena| last7= Lilenfeld|first7 = Scott O.| year = 2022| title=Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework| journal = Annual Review of Clinical Psychology| volume = 9| number = 18 |pages = 259-289|doi=10.1146/annurev-clinpsy-081219-102424}}</ref>