A new model of dissociative identity disorder.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision [1] (DSM-IV-TR) describes the classic features of dissociative identify disorder (DID) that are widely known in the general culture. According to the DSM-IV-TR description, a person who has DID switches from one personality to another; each personality has its own identity; and the host personality has amnesia for the activities of the other personalities. I have argued that this description of DID is deficient because it omits most of the dissociative phenomena of DID [2–4] and focuses solely on alter personalities. This article presents data from 220 persons who have DID and explores how those data fit with three contrasting models of DID: (1) the DSM-IV’s classic picture of DID (ie, multiple personalities þ switching þ amnesia), (2) Dell’s subjective/phenomenological model of DID [4], and (3) the sociocognitive model of DID. The DSM-IV narrowly portrays DID as an alter disorder, whereas the subjective/phenomenological model portrays DID as a far more complex dissociative disorder that is characterized by recurrent dissociative intrusions into every aspect of executive functioning and sense of self. The subjective/phenomenological model of DID subsumes the DSM-IV model of DID, but not vice versa. The sociocognitive model argues that DID is a socially-constructed, iatrogenic condition.