Archive for November, 2007

I looked up a review of MPD/DID treatment practices, and their effects. I’m skipping the extensive and disturbing description of the lengths practitioners go to in order to elicit alters, but it includes things like spending 4-8 hours in therapy without breaks attempting to elicit personalities (i.e., you don’t get to go home till you show me a personality), and taking momentary silence or a glance around the room to indicate a switch in personalities.

Selections from the article:

This proliferation of alters is typically accompanied by clinical deterioration that is often quite marked. In one investigation, more than 8 of 10 patients “developed florid posttraumatic stress disorder during [DID therapy]”; the authors commented that this result is typical (6, p 361). Hallucinations, increasing discomfort, and severe dysphoria often cause patients to be in states of chronic crisis for long periods of time after DID treatment begins (9,11,52–54).
Moreover, suicide attempts may occur in the weeks following the diagnosis: Fetkewicz and associates showed that, after the diagnosis had been made, MPD-diagnosed patients attempted suicide more frequently than age- and sex-matched patients suffering from major depressive disorder (55). In another study, 4 of 5 MPD patients improved dramatically when they were rediagnosed and treated in more conventional ways (56).

Such deterioration should surprise no one, given the treatment practices that leading DID proponents recommend. These proponents believe that successful treatment requires DID patients to search their memories for each supposed trauma and then to abreact (that is, experience in therapy) the memories and associated emotions (1,11,57). Such searches frequently consume hours of each day, and the abreactions are extremely draining (58,59). Patients thus sink ever more deeply into a swamp of ruminations about past mistreatment, abuse, and trauma.

(emphases mine)

We don’t have a lot of research on this, unfortunately. It would be nice to have more. Part of it is for the reason the article talks about – in practice MPD/DID is often specified in ways that dodge testable definitions, which sets things up so that you can’t ever find out that a diagnosis is wrong, regardless of whether it is. Part is because it’s fringe, which is unfortunate because it’s also important.

This is in agreement with other research I’ve read – eliciting alters is a good way to get someone’s mental health to deteriorate. I’ve heard this cited as a reason that a lot of North American MPD clinics have closed, but I don’t know if that’s really the reason; my guess would actually be that they closed because they weren’t getting new patients, not because they were serving their old patients poorly.

Here is part 1 of the article above (with a historical review of MPD).

New idea: Kids with attention deficit disorder are just late bloomers.

This is not being said (at least outright) by some major news outlets like ABC and Time, although the public is jumping on it.

To their (minimal) credit, Time even noted that the study has not been peer reviewed (meaning no one other than the researchers has yet evaluated their work, and it should not yet be being reported as fact), and a number of news outlets are even reporting that the study only found that about half the kids catch up to their peers.

An article in the NY Times even mentioned the fact that the study wasn’t about ADHD. Not the article on the front page, but an article in the opinion section, in which the author reports actually contacting the researcher to verify their findings.

Greg J. Duncan, a professor in the School of Education and Social Policy at Northwestern University and the lead author of the school study, was somewhat mystified that his research – which attempted to understand the links between kindergarteners’ math, reading, attention-paying and “socioemotional” skills and their later academic achievement – was being discussed in the same breath with ADHD at all. The study, he said, wasn’t “about clinical levels of attention problems.”

This was true. Duncan’s research didn’t measure the effect of ADHD on future achievement; in fact, it made no mention of ADHD at all.

As a quick note: Often kids with developmental disabilities have delayed maturation of skills/abilities (and often don’t catch up entirely). This is one of the core impairments in kids with autism or Asperger’s. Delay in maturation doesn’t necessarily mean things will turn out fine if you just wait. What it does mean is that children with delays like this are hitting developmental and social milestones unevenly. As a (possibly more extreme) example, someone who doesn’t learn to speak until they’re nine – even if they catch up to normal levels by the time they’re 18 – is not going to have the same set of educational or social experiences that their normally-developing peers do.

Some people develop symptoms that could indicate future schizophrenia, but never actually develop it.  Other people with the same symptoms do. The better we get at telling who will and who won’t develop schizophrenia, the better we can treat it.

Anxiety, Addiction, Depression, and Depression Treatments reports on a study that exposed people with symptoms indicating possible future schizophrenia to a mix of six voices speaking simultaneously.  It was designed so that only four words were clearly audible in the noise.  When asked to describe any words they heard, most people reported words and phrases that were not spoken.  The interesting finding, though, was that 6% who reported phrases under three words developed schizophrenia within two years – but 80% who heard phrases of four or more words did.

This doesn’t tell us whether the under-three-words people will ever develop schizophrenia, but it suggests a time frame in which most of them won’t, and a time frame in which many of the four-words-or-more people will.

I hope this finding holds up!  An easy test that could help doctors know who best to medicate to help avert development of full-blown schizophrenia could mean a lot fewer people developing it.