Talk:Dissociative identity disorder/Archive 10

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The lead is bad again

The new version of the lead simply reintroduces all the old problems. Most of the current focus of the current lead is on relatively unimportant details that people can go to the body of the article to find out for specifics. Almost f the entirety of the changes were to minimize all mention of the controversy and hide it behind jargon that most people here will not understand.

While all DSM diagnoses are controversial, it is a bit disingenuous to claim that the controversy on this one doesn't need much space in the lead because of rampant controversy. The *kinds* of controversy and level of controversy between this diagnosis and others are quite a bit different. Very few people dispute schizophrenia exists at all or think that people who report symptoms are doing so because their therapist talked them into it.

From comments above I am not surprised that Mathew is whitewashing the article, but I am very disappointed in DocJames. To pretend that this isn't a more controversial diagnosis than most while at the same time provided a quot from a reliable source on the talk page to the contrary is really bizarre.

Unless these concerns are addressed I will revert back to the previous version. WP:NPOV policy is very clear on this. DreamGuy (talk) 22:24, 29 July 2012 (UTC)

I vote against reverting. The lede is the best I have seen ever on this article. In addition, we are working on it. Please work with us instead of doing what is always done here, totally reverting all work. Please help us work on a good article for WP.~ty (talk) 22:29, 29 July 2012 (UTC)

The lede is just a start. It's not meant to be a finished product. Doc James (the expert both WLC and I called in) thinks its a good start. It got rid of all the irrelevant stuff from the lede and made it easier to edit the article. The prior one didn't follow WP:LEAD, while now we can build the lede from the article. The "controversial" stuff is not in reality nearly as important as the article makes out. Yes, there is a lack of knowledge but most mental health professionals are not immersed in controversy over DID. I vote against a revert. MathewTownsend (talk) 22:40, 29 July 2012 (UTC)

It is your *opinion* that the controversy isn't important. That is not the opinion of several experts. We go by what the experts say, not by the personal beliefs of editors here. To say that the controversy is only due to lack of knowledge when people simply do not know about the topic is nonsense when much of the controversy is coming from within the field itself. And, yes, it comes from outside too, which we also ought to cover. So far your arguments have all boiled down to what you believe and not what Wikipedia policies say we should do. DreamGuy (talk)

Reply to Mathew - Exactly! I agree that it is a good start and we should keep working on it.~ty (talk) 22:46, 29 July 2012 (UTC)

First of all I never stated that this disorder is not more controversial than most. I simply stated that they are all controversial to one degree or another. The lead contains "DID is one of the most controversial psychiatric disorders with no clear consensus regarding its diagnosis or treatment." after I updated it. ADHD has also been called the most controversial pediatric diagnosis. We discussion this controversy within the forth paragraph there. And discussing the controversy in the forth paragraph here makes sense as well. That is 25% of the lead which should be sufficient weight. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 22:53, 29 July 2012 (UTC)

If I inadvertently misrepresented your stance, I apologize. The version of the lead had one to two sentences maximum on the controversy itself and did not even include the word controversy. I personally can agree that 25% of the lead is reasonable -- provided that the rest of it does not include content that violates NPOV by presenting highly disputed information as if it were not disputed. I am trying very hard to be reasonable and in no way want to give any side undue weight, but it seems like a couple of people here don't get that at all. DreamGuy (talk) 23:19, 29 July 2012 (UTC)

With respect to Wikipedia policy DreamGuy has support to revert to the previous version. One is not to start an edit war following this but to start a WP:RfC. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 23:20, 29 July 2012 (UTC)

Question for Doc - What do we need to work on to make the current version something that is not bait for reversion? Give me a task and I am on it!~ty (talk) 00:46, 30 July 2012 (UTC)

Consensus for the Dx and treatment of DID

Can we agree that this is a misleading statement that is currently in the lead? "Consensus is NOT lacking in the diagnosis and treatment of DID." I would think that the DSM-IV gives a consensus for a Dx of DID and the 2011 revised treatment guidelines ISSTD gives the guidelines for the treatment of DID. If this is not enough here is a [http://psycnet.apa.org/psycinfo/2011-28153-001/ current review article by some major brains in the area of trauma and DID: Brand, Bethany L.; Myrick, Amie C.; Loewenstein, Richard J.; Classen, Catherine C.; Lanius, Ruth; McNary, Scot W.; Pain, Clare; Putnam, Frank W. . This review appears to agree with the 3 phase method already widely in use and suggested by the ISSTD.~ty (talk) 21:12, 29 July 2012 (UTC)

I changed the lede - see what you think. Though ISSTD is not a reliable source, being an advocacy organization, so can't be used. MathewTownsend (talk) 21:20, 29 July 2012 (UTC)

What I think! Here is a huge cyber hug!!!! How about the Brand et al review? ~ty (talk) 21:21, 29 July 2012 (UTC)

I do not see concerns with the changes by Mathew. Some of the content however maybe should have been moved lower in the article if not already there.

With respect to consensus regarding DID we have this reference here "Dissociative identity disorder (DID) is probably the most disputed of psychiatric diagnoses and of psychological forensic evaluations in the legal arena." from a 2008 review article [1]. Maybe the wording could be improved? Many if not all of the diagnosis in the DSM are controversial, not just this one :-) Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 21:27, 29 July 2012 (UTC)

Reply to Doc - Exactly! What makes DID such a target is that child abuse (as a cause) is involved - from what I have read in many professional sources.~ty (talk) 22:10, 29 July 2012 (UTC)

Reply to Doc and Mathew - Yes - from all I have read, this is how I see what the words controversy mean. Feel free to use any of my text here: Ignorance surrounds the valid psychological diagnosis of dissociative identity disorder, a mental disorder that is included in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) and the proposed DSM 5 - a serious mental disorder which is at least as common as Schizophrenia.

Also from what I have read from many experts, the existing "controversy" has a lot to do with severe child abuse and the a percentage of the public's denial that such child abuse even exists even though we read about it in newspapers.~ty (talk) 21:44, 29 July 2012 (UTC)

re controversy. I agree. I think all too much emphasis is placed on the controversy in the article (when controversy is endemic in psychology/psychiatry) and not enough on our lack of knowledge and the true confusion that surrounds this diagnosis and personality functioning in general. It's a much more interesting topic when explored as knowledge seekers than in taking sides over a controversy. MathewTownsend (talk) 21:52, 29 July 2012 (UTC)

Reply to Mathew - Yes! A voice of reason!~ty (talk) 22:06, 29 July 2012 (UTC)

(edit conflict)

• Please improve the wording in the lede! And I know also it's not complete. I just wanted to take the lede down a few notches in tone. MathewTownsend (talk) 21:41, 29 July 2012 (UTC)
• Re Brand, Bethany L; etc. - I would say no. It's a survey of practices and recommended treatment interventions among 36 international expert therapists treating patients with dissociative identity disorder and dissociative disorder not otherwise specified. How were these "experts" selected? Seems like a small number to survey internationally, so likely not representative of therapists or "experts" treating these patients. MathewTownsend (talk) 21:41, 29 July 2012 (UTC)

Reply to Mathew - Me? I am allowed to edit the page or Doc James? I would prefer to put it here and one of you edit or it will probably just be reverted.~ty (talk) 21:51, 29 July 2012 (UTC)

Reply to Mathew - I will check the library and see what I can find to answer your questions, but this is a review. Is it less of a work than other articles used on the DID page?~ty (talk) 21:47, 29 July 2012 (UTC)

If you look at the article on ADHD another very controversial diagnosis. We give controversy a paragraph in the lead. We need to let the literature lead.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 23:09, 29 July 2012 (UTC)

Reply concerning the Brand et al article- this work is akin to a review of studies each of which reports case study results. It's what you do when you have nothing better. It's a beginning. We'd all like something better, but if this is the best we have, we go with it and make clear that our generalizations are standing on the ground we'd prefer. To just dismiss this is not correct unless you have something better to use. In addition, one of the authors is Frank Putnam, the Frank Putnam, Chief of the Unit on Dissociative Disorders, Laboratory of Developmental Psychology, Intramural Research Program, National Institutes of Mental Health. He was a member of the DSM-IV Work Group on Dissociative Disorders. He's not ever going to put his name on any publication that isn't top notch. His was one of the first books I ever read on DID.~ty (talk) 00:51, 30 July 2012 (UTC)

Unable to find the Brand article in pubmed? Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 16:05, 30 July 2012 (UTC)

Could it be because it quite new Dec 2011? I can't get it on pubmed either or anywhere but here.

citation: A survey of practices and recommended treatment interventions among expert therapists treating patients with dissociative identity disorder and dissociative disorder not otherwise specified. Brand, Bethany L.; Myrick, Amie C.; Loewenstein, Richard J.; Classen, Catherine C.; Lanius, Ruth; McNary, Scot W.; Pain, Clare; Putnam, Frank W. Psychological Trauma: Theory, Research, Practice, and Policy, Dec 5 , 2011, No Pagination Specified. doi: 10.1037/a0026487 ~ty (talk) 16:37, 30 July 2012 (UTC)

Discussion about what goes in the Lead/Lede

Note: this used to be a direct response to something Tylas wrote above. Since I wrote it that whole section was changed by Tylas to read something else entirely. This is an ongoing problem here. The prevalence information does not belong in the lead. It is highly disputed, especially as critics either say it has been vastly overdiagnosed or may not even really exist. Putting these numbers without a very clear explanation of the controversy is a huge violation of NPOV policy. DreamGuy (talk) 22:28, 29 July 2012 (UTC)

Prevalence information does belong in the lead. And Doc James supplied the references for it and also said the ratio of male to female with the disorder should be there. MathewTownsend (talk) 22:50, 29 July 2012 (UTC)

Well then we disagree, strongly at that. If the prevalence is listed, then we explicitly need to explain that other sources dispute those numbers. To do otherwise would blatantly slant the article. I have no problems with the gender ratios being in the article itself somewhere, but in the lead it would be too specific of a detail when there is a lot more valuable information that deserves to be there. DocJames was talking about the length of the lead, and if we are imposing some length, then we need to pick the most important information, which is: 1) short summary of what it is, 2) that it's controversial and why, 3) other stuff if there's room. I also think some commentary on how experts would explain that the ratios of diagnosis are so vastly different between genders would be useful later in the article. DreamGuy (talk) 23:07, 29 July 2012 (UTC)

I reverted my own edit. I missed the new references and such. My apologies! ~ty (talk) 23:04, 29 July 2012 (UTC)

There is a lot of high quality recent literature that gives prevalence rates. They do mention that the quality of the data is poor. Thus I have added this. Still think the numbers are significant enough to deserve mentioning. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 00:52, 30 July 2012 (UTC)

The approach of "X is the estimated prevalence/recover/incidence/temperature but this is controversial" is my preferred approach to these things - we should note what the best guess is. If that best guess is controversial - we must note that as well. Best is if we can say why it is controversial, but the lead will probably be very long anyway and that might be too much detail. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:22, 30 July 2012 (UTC)

How is the lead in "There is little systematic data on the prevalence of DID"? Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 03:13, 30 July 2012 (UTC)

More problems with the lede

I am only addressing (for right now) the parts that were left in the lede before Dreamguys revert. Afterwards there is a host of errors to address!

Problem in the lede: http://www.ncbi.nlm.nih.gov/pubmed/18569730 It is ref #8 on the DID article This is a poor abstract that lays out a problem, then says what "the paper" will address. But no results or conclusions are reported.Research on treatment effectiveness always focuses on "clinical approaches", and at the beginning of a body of research the focus is always on case studies: "I took a client and did treatment X and here's what happened. Now we need a clinical study of a sample, etc." ~ty (talk) 00:07, 30 July 2012 (UTC)

Another problem with the lede: "No systematic, empirically-supported approach exists." Kluft's report of over 200 of his cases yields a sustained full remission at 5 years after termination of treatment of ~85%.~ty (talk) 00:18, 30 July 2012 (UTC)

And another problem in the lede: "DID does not resolve spontaneously, and symptoms vary over time." What is the point of this sentence? Why is it in this paragraph? ~ty (talk) 00:20, 30 July 2012 (UTC)

Another problem in the lede: "In general, the prognosis is poor, especially for those with co-morbid disorders." It is poor unless one gives appropriate treatment, a summary of which is detailed in Howell book.. Howell treatment model contains improvements: specific, proven therapy for trauma (something which Kluft says he always found necessary) - EMDR. So we might now reasonably assume that a treatment success rate of 85% is a lower limit of what good treatment would achieve. This makes treatment of DID more successful than the great majority of mental health disorders.

Best to try to fix the body of the text first and the lead second. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 00:54, 30 July 2012 (UTC)

Will do Doc, but I was already working on the lede so I put that info here were it won't be lost.~ty (talk) 00:57, 30 July 2012 (UTC)

Have found a reference for one of the statements with respect to spontaneous resolution. The section on prognosis however could use expansion.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 00:59, 30 July 2012 (UTC)

Cause

I am working on prognosis right now, but if anyone is doing cause, I found a good 2008 pubmed review article on DID. J Trauma Dissociation. 2008;9(2):249-67.Familial and social support as protective factors against the development of dissociative identity disorder. Korol S.~ty (talk) 03:12, 30 July 2012 (UTC)

• This is another great reference that gives a good 10 page overview. Could probably be used a dozen times or more. http://books.google.ca/books?id=2RzFWRIAsPAC&pg=PA681 And bring this page a ways to GA.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 03:32, 30 July 2012 (UTC)

Prognosis

I am working on this section here. I am reading a bunch on this, since of all the aspects of DID to study, this is the one that I have not looked into in depth, so this is interesting. Help is always greatly appreciated! ~ty (talk) 13:27, 30 July 2012 (UTC)

This is what I have. Anyone have suggestions or changes for this? First is the text for the DID page, followed by support for the last sentence.

Generally, the earlier one is diagnosed the better the prognosis and even greater if diagnosis and treatment is obtained during childhood. Prognosis becomes far less optimistic if not appropriately treated. Successful treatment (psychotherapy) for adults usually takes years depending on ones goals; to operate as a unified self and free of the effects of DID or become coconscious, still having DID. If the typical 3 phase treatment for DID is completed, dissociative boundaries are reduced resulting in a unified self and elimination of the effects and symptoms of trauma memories. Therapy is not easy and hospitalization can be required for some patients. This chronic disorder rarely resolves spontaneously if ever. [2][3] [2] Individuals with primarily dissociative symptoms and features of post traumatic stress disorder normally recover with treatment. Many patients have a history of being sexually abused as a child and often cope by abusing alcohol or other substances - a negative way of coping with their victimization. Those with co-morbid addictions, personality, mood, or eating disorders face a longer, slower, and more complicated recovery process. Individuals still attached to abusers face the poorest prognosis; treatment may be long-term - and consist solely of symptom relief rather than integration. Changes in identity, loss of memory, and awaking in unexplained locations and situations often leads to chaotic personal lives. [3] Individuals with the condition commonly have histories of failed suicide attempts and self-harm. [4][5][6] ~ty (talk) 16:22, 30 July 2012 (UTC)

Can you put references inline? Typically for a controversial topic every line should have a reference behind it. Also if you use the "quote=" you can stipulate what text from the source supports your paraphrasing. The last line also pertains to treatment not prognosis. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 16:37, 30 July 2012 (UTC)

Thanks Doc! I can and will do so quite happily! ~ty (talk) 16:41, 30 July 2012 (UTC)

Well darn - let's move that last and all that supporting information to treatment!~ty (talk) 16:41, 30 July 2012 (UTC)

It we could be more specific when it comes to referencing by adding the exact quote from the reference in question that would make things easier. Typically our paraphrasing should not be much different than the original. Here is a an example.

Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 21:08, 30 July 2012 (UTC)

Reply to Doc James - I can do that. I felt like I was stealing when doing that. I had read in WP rules that we are suppose to write things in our own words, but I can see how it will reduce conflict with some editors. Thank you. :) ~ty (talk) 21:44, 30 July 2012 (UTC)

Question on reference - For this section that WLU deleted before I had a chance to ask you if this book was okay to use: Prognosis becomes far less optimistic if not appropriately treated. {citation needed} Successful treatment (psychotherapy) for adults usually takes years depending on ones goals; to operate as a unified self and free of the effects of DID or they might choose to become coconscious and still have DID. {citation needed}

Attachment, Trauma and Multiplicity working with DID by V. Sinason 2011

It's not a major text book, but the info above is a bit beyond a text book. It is a major work on DID however. Sinason~ty (talk) 21:42, 30 July 2012 (UTC)

It is safest to stick with major textbooks at least initially. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 22:45, 30 July 2012 (UTC)

I am really starting to see why! I am getting confused! Break time! Thanks Doc!~ty (talk) 22:51, 30 July 2012 (UTC)

Treatment

DID treatment is supported by a body of prospective data in a well-defined population using valid and reliable measures of psychopathology.

Support for this statement

Summary of Ross and Halpern (2009): Ideally, treatment outcome studies are "...randomized, prospective, double-blind placebo-controlled.." designs. "Prospective" means we start with a condition, apply treatment, then see what happens. Most DID studies are retrospective - we're done with treatment, and we look back. This is important because retrospective studies do not have dropouts, a significant issue in proper studies.

Where DID is concerned, there are multiple essentially insurmountable hurdles here:

• Psychotherapy clients usually can figure out if they are receiving placebo (there goes half of the "blind");
• Whereas a typical drug treatment study lasts 6-8 weeks, DID treatment lasts years (5 or more); it is therefore far harder to retain study subjects in DID studies than in drug studies. Most psychotherapy last far less time than does DID therapy, so the problem is not just in comparison with drug studies.)It is not feasible, nor ethical to offer someone in need of treatment a placebo for years.
• For many reasons, obtaining funding for treatment outcome studies in DID is significantly more difficult than with other conditions.

What this means is that there likely will not be a really good treatment outcome study for DID any time soon, if indeed ever. The hurdles are really big. Therefore, in the meantime acceptance of other studies if the norm.

Next, we look at treatment outcome studies in mental health. Here, they look only at medication. There is no mention of psychotherapy models other than theirs. This is a major flaw of their analysis, for a reason that may not be obvious. Basically, psychotherapy typically gets better results than do drugs. For many technical reasons Ross and Halpern (2009) summarize psychotropic medication, in general, as not especially effective. Reported successes are almost surely inflated due to inherent research design errors.

Moving to DID, Ross and Halpern (2009) comment that these "patients" are so complicated that they would simply be excluded from normal treatment studies, because: most have been psychiatric inpatients or have been suicidal, and most have other Axis I disorders including addictions. Such subjects just are not used in treatment studies - too many factors are in play to do a good study.

They then present treatment outcome data for participants in their treatment program in Texas.

• Ross and Halpern's (2009) data is prospective, but not randomized, double-blind, or placebo controlled.
• All subjects were given formal assessments (involving objective tests) at admission, at discharge (an average of 18 days later), and at 3-month followups.
• All 46 participants had a dissociative disorder (DID or DDNOS - no one gets hospitalized for the others), and major depression, at admission; 85% had borderline personality disorder; 59% had somatization disorder; 48% had a substance abuse disorder. Remember, these are inpatients - the most serious subgroup of the DID diagnostic group. Non-inpatients will not look so complicated, and will respond to treatment better.
• As a group, objective assessments of symptoms showed significant improvement at discharge, with continuation of improvement seen at 3-month followup.
• A separate, more detailed, two-year follow-up study of 54 graduates of their treatment program revealed that 12 (22%) had achieved stable integration at that point. Why not more? Because at admission they were at all stages of recovery, with some having been diagnosed only a few months earlier, and full treatment usually requires at least 5 years, they say. They estimate that at 5 years, 50% will have achieved integration. This recovery rate is as good as that for recovery from depression using medication, and with simple subjects who don't have all sorts of complicating, interfering factors.
• None of those achieving integration in their 2-year study had any kind of substance-abuse problem.

My conclusion from the Ross and Halpern (2009) book: "The treatment techniques described in this manual are supported by a body of prospective data in a well-defined population using valid and reliable measures of psychopathology."

Do you have a PMID for reference in question or an ISBN and page number / google book url? Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 16:51, 30 July 2012 (UTC)

You don't have this wonderful book on your bookshelf? ;) of course. Here you go: Ross book and here is more: {{cite book|last=Ross|first=C.|title=Trauma Model Therapy: A Treatment Approach for Trauma Dissociation and Complex Comorbidity|year=2009|publisher=Manitou Communication|location=TX|isbn=098218512X}

Hum prefer that we use major textbooks... This may be okay for some stuff but the book I gave above would be less questioned.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 18:38, 30 July 2012 (UTC)

Repy to Doc - Worry not! :) I am, as we type, adding references from both Merk Manual and the book you gave on the prognosis section - since much of the original text that was there was from the Merk Manual online. It is an awesome book ref by the way and as you said - it can be used for many things in this article! I was just working on that other project before you posted it since the entire book is on treatment. It's a good one! ~ty (talk) 18:44, 30 July 2012 (UTC)

Brand et al. 2011 is an interesting read, which emphasizes the lack of clear evidence for DID treatment, having instead to rely on the impressions of clinicians. Oddly it doesn't appear to be pubmed indexed. It's also a bizarre primary-looking document (but used three times in the article already). WLU (t) (c) Wikipedia's rules:^simple/_complex 20:13, 30 July 2012 (UTC)

Taken out of context

Never mind~ty (talk) 22:42, 30 July 2012 (UTC)

• I'm not sure what the problem is with this.

Traditionally dissociative disorders such as DID were attributed to trauma and other forms of stress that caused memory to separate or dissociate, among other symptoms, but research on this hypothesis has been characterized by poor methodology. So far, experimental studies, usually focusing on memory, have been few and the research has been inconclusive. It became a popular diagnosis in the 1970s but it is unclear if the actual incidence of the disorder increased or only its popularity. An alternative hypotheses for its etiology is that DID is a product of techniques employed by some therapists.

• It's meant to give a brief summary of the history in the lead. In the lead, citations are discouraged in general, because everything in the lead with be explained in the article with citations (though controversial material should be cited there. I meant it to summarize the "controversy" without becoming bogged down in it, so we could get on with the article. Once we write the article, we'll know what to put in the lead. Currently the lead is just a "stand-in" as it will have to contain a concise summary of the major points in the article, and there are many, many points that are going to end up in the lede (lead). MathewTownsend (talk) 22:28, 30 July 2012 (UTC)

Never mind! Now it makes sense. I thought WLU did it, which was so totally confusing to see what he was getting at. Ignore this section!~ty (talk) 22:41, 30 July 2012 (UTC)

I understand now. It was just so unlike WLU and I became confused. Really paranoia is not a sign of DID. ~laughing Should I just delete this whole section. It might be very confusing to others who read it.~ty (talk) 23:13, 30 July 2012 (UTC)

Best to work on the body of the text first and the lead last

The section on epidemiology is full of primary research papers. Are there not secondary sources that give ranges for different populations? Once this section and the controversy surround prevalence has been improved here than a smaller summary can be added to the lead. My comments above on gender ratios belong here not in the lead. Belong in both spots maybe... Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 23:29, 29 July 2012 (UTC)

• Reinders, A. A. T. S. (2008). "Cross-examining dissociative identity disorder: Neuroimaging and etiology on trial". Neurocase 14 (1): 44–53. DOI:10.1080/13554790801992768. PMID 18569730 is a primary article, not a review, and is cited 8 times in the article. MathewTownsend (talk) 00:31, 30 July 2012 (UTC)

• Pubmed does list this as a review article and that is typically what I go by.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 01:28, 30 July 2012 (UTC)

• Farrell, H. M. (2011). "Dissociative identity disorder: Medicolegal challenges". The journal of the American Academy of Psychiatry and the Law 39 (3): 402–406. PMID 21908758 is cited 5 times in the article and is a primary source and not a review article. MathewTownsend (talk) 00:37, 30 July 2012 (UTC)

Yes, agree with both points. Casliber (talk · contribs) 00:39, 30 July 2012 (UTC)

I don't understand why this is being described as primary and not a review article. Please explain your reasoning instead of just assertnig it. DreamGuy (talk) 02:41, 31 July 2012 (UTC)

• Putnam, Frank W. (1989). Diagnosis and Treatment of Multiple Personality Disorder. New York: The Guilford Press. pp. 351. ISBN 0-89862-177-1. RW (2002). "The duality of the brain and the multiplicity of minds: can you have it both ways?". History of Psychiatry 13 (49 Pt 1): 3–17. DOI:10.1177/0957154X0201304901. PMID 12094818. This is a primary and not a review article, yet is cited 4 times in this article. MathewTownsend (talk) 00:42, 30 July 2012 (UTC)
• van der Kolk BA, van der Hart O (December 1989). "Pierre Janet and the breakdown of adaptation in psychological trauma". Am J Psychiatry 146 (12): 1530–40. PMID 2686473. Primary source cited 2 times. MathewTownsend (talk) 00:58, 30 July 2012 (UTC)

I would support the retention of the primary sources DocJames removed from the epidemiology section (here). Again pointing to MEDRS, WP:MEDREV seems to use this sort of situation as an example of when a primary source would be appropriate (they use average age of onset for autism, estimated percentages in specific countries seems similar to me). This is mostly because I don't think there are review articles going into the numbers the way these primary sources do, particularly in these countries. Natch, if someone can find one then that's better, but until this point I think they're a reasonable inclusion.

I'm really not sure how these articles are considered primary. In my experience, primary means a study performed on a group of subjects while secondary synthesizes multiple primary articles. Per Wikipedia:MEDRS#Definitions, these would seem to fit the examples given ("Examples include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations."). They may not be meta-analyses or systematic reviews, but they do seem to be literature reviews that verify relatively uncontroversial points for the most part. In the case of Reinders and Rieber, they're secondary sources (as I understand them, again I'm surprised to see these considered primary) discussing areas the authors have specific expertise in, neuroimaging and the history of psychiatry. Farrell doesn't seem to be a lawyer, but has published two articles (though very similar ones!) on DID and the law. The Putnam books should be replaced if possible, and I'm not upset by removing them outright.

I would be very surprised to have been so wrong for so long. Doc and Casliber, you think that the Reinders, Rieber and (both, there are two) Farrell articles should be removed as primary sources? WLU (t) (c) Wikipedia's rules:^simple/_complex 01:15, 30 July 2012 (UTC)

Mathew, while I agree that medical literature changes pretty quickly, making information obsolete within five years or so, I wouldn't argue the same for historical information. Putnam, 1989 for instance, is cited solely in the history section, which is one place where I think older sources (if not contradicted by newer sources) are acceptable. I think the same goes for Rieber as well, since legal doesn't change the same way medical does. I would be more concerned if these were 20-year-old sources used in the diagnosis, treatment, etiology or other specifically "medical" sections. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:19, 30 July 2012 (UTC)

This very large textbook of psychiatry gives numbers and is better than the primary sources that where there before IMO. It also discusses how rates have changed with time. Schatzberg, edited by Robert E. Hales, Stuart C. Yudofsky, Glen O. Gabbard ; with foreword by Alan F. (2008). The American Psychiatric Publishing textbook of psychiatry (5th ed. ed.). Washington, DC: American Psychiatric Pub. pp. 681–682. ISBN 9781585622573. {{cite book}}: |edition= has extra text (help); |first= has generic name (help)CS1 maint: multiple names: authors list (link)

ADHD is a similar condition which went from being very rare to being exceedingly common with similar associated controversy. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 01:21, 30 July 2012 (UTC)

I agree that for the sections on history as well as "society and culture" which includes legal we need not be as stringent on referencing. Yes these are sort of literature reviews but not marked as such by pubmed (except for the first one which is listed as a review article). I have had this question myself and will touch base with pubmed. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 01:24, 30 July 2012 (UTC)

Doc, I agree that we need to do the body first and the lead should be based upon the body. Unfortunately that's not what recent edits were doing. The gender disparity, for example, is interesting and definitely deserves a place in the body, but it got added the the lead right away and then tacked on to the body as an afterthought. Out of all the wide things that can be in the lead, something that was just tossed together and up to this point anyway showed no overall notability seems like an odd choice. And I say that as someone who put that back into the lead when reverting to the old consensus version because nobody objected to it. (As mentioned above, I think experts talking about why they think the gender disparity is there -- or if there are any studies on that specific topic somehow -- would be very valuable to the article, as compared to tossing it out there as a factoid.)

Recent discussions on the controversy suggested it shouldn't be there because there was no controversy section, which is missing the point entirely. The things mentioned in the lead that some people tried to remove (or reword so that it was incomprehensible to an average reader) are fully detailed in the body of the article in various places. They were being removed despite the fact that they accurately summarized the article. And we have discussion on this very talk page that explained all of that already, multiple times. It is incomprehensible how someone who was advocating editing the lead last was busy chopping it to pieces and adding wholly new material never before present in the article. DreamGuy (talk) 02:34, 31 July 2012 (UTC)

Good Article status first step to a stable version

I recommend working this up to GA status as this is then a consensus version that folks can refer back to when problems arise in the future. FA would be better but probably a tad ambitious.....Casliber (talk · contribs) 00:51, 30 July 2012 (UTC)

Another helper! Yay! Thank you Sir for being here!~ty (talk) 01:00, 30 July 2012 (UTC)

I agree, Casliber, and so thankful that you turned up. I know how busy you are and so I'm all the more thanful. MathewTownsend (talk) 01:42, 30 July 2012 (UTC)

There's no hope for GA status while edit warring is going on and brand new changes that violate policy are being added daily. We already do have a working consensus version that folks can refer back to when problems arise, however. Nobody is happy with it, but nobody can agree on specifically what should be changed. DreamGuy (talk) 02:26, 31 July 2012 (UTC)

Controversy

While we do not typically have sections on controversy. Maybe in this article like for ADHD we should? We could put this text there?

DID is a controversial diagnosis. Supporters attribute the symptoms to the experience of pathological levels of stress, which they say disrupt normal functioning and force some memories, thoughts and aspects of personality from consciousness (dissociation); an alternative explanation is that belief in these dissociated identities is artificially caused by certain [[psychotherapy|psychotherapeutic]] practices and increased focus from the [[mass media|mass media]], leading the patients to imagine symptoms that did not exist prior to therapy. The debate between the two positions is characterized by intense disagreement.

Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 01:36, 30 July 2012 (UTC)

I agree that a controversy section is needed somewhere, and the above catches the gist of it well. Casliber (talk · contribs) 02:05, 30 July 2012 (UTC)

Actually I disagree, and think WP:STRUCTURE would apply. The thing is, the controversy over DID, from what I've read, exists in nearly every section. You can find criticisms of the epidemiology, the etiology (particularly the etiology actually), the diagnosis, the history, the diagnosis, pretty much everywhere has someone venturing a criticism of the traumagenic position, with a comment, rebuttal or counter-criticism from someone from the traumagenic camp. This is part of why the article is hard to write, there's at least two positions for every section. Having a single controversy section either reduces the controversy by making it appear like it's a fringe position, or does exactly what STRUCTURE says the page shouldn't - forces you to read the whole page twice because once you reach that section you realize there's a whole other view that's not expressed.

That being said, sometimes it is hard to tease out the controversies as many of them to span multiple sections. WLU (t) (c) Wikipedia's rules:^simple/_complex 11:05, 30 July 2012 (UTC)

Agree with Casliber, James and Santos - WLU, with all due respect Sir you have stated before that you have no interest in reading about the trauma etiology of DID - perhaps if you did, the controversy you feel is present would ease. There is an accepted view of DID etiology and there is a very select minority that has a different view. I agree with Casliber and Doc James on their proposed setup on this issue - which is also what Daniel Santos proposed up at the top of the talk page a couple of weeks ago.~ty (talk) 14:07, 30 July 2012 (UTC)

The etiology is accepted only by a portion of the mental health community. Traumagenesis is not considered the universal and uncontroversial cause of DID the way bacterial infection is the cause of a urinary tract infection. Per WP:NPOV, both need to be represented and neither should be portrayed as the "right" one. It's controversial and contested. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:19, 30 July 2012 (UTC)

Those are good point WLU. Agree most of the discussion of different aspects of each section as long as well referenced (controversial or not) should take place in that section. I guess a specific section on controversy would be only if one position was not main stream or coming from a social or political group rather than a scientific one. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 16:03, 30 July 2012 (UTC)

Moving all controversial content to the bottom

This is not what I meant. Thus I have moved the content that was moved in these edits [2] and [3]. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 20:47, 30 July 2012 (UTC)

Doc, there are already parts of the article talking about the controversy (at least there was last time I checked, but with the edit warring it may have all disappeared again). The lead is supposed to summarize the article, which is why the part you suggested moving was in the lead in the first place.

Also, generally speaking it's not a good idea to create a specific controversy section and move all criticism to that area. This essentially creates a ghetto area where those with a POV can try to minimize a viewpoint, and that's one step away from moving. Controversies should be explained organically as the various topics arise. Controversies about causes should be covered in the causes section. Controversial aspects in the history are covered in the history section. Avoiding controversy sections is a principle explained in one of the NPOV policy pages (or, again, it used to be, sometimes things get deleted). DreamGuy (talk) 01:46, 31 July 2012 (UTC)

As you will have noted I have replaced some of the content surrounding controversy back in the lead. And tried to keep aspects that some view as controversial within the usual section. Have moved the section on controversy to diagnosis as that is what the controversy deals with.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 01:49, 31 July 2012 (UTC)

Please see Wikipedia:Criticism#Avoid_sections_and_articles_focusing_on_.22criticisms.22_or_.22controversies.22. DreamGuy (talk) 01:51, 31 July 2012 (UTC)

Yes you are right. Will need to look at thinks further. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 01:53, 31 July 2012 (UTC)

That's an essay, but it's elaborating on a policy, WP:STRUCTURE. WLU (t) (c) Wikipedia's rules:^simple/_complex 03:37, 31 July 2012 (UTC)

The lead must discuss the controversy

Tylas reverted my edit with the summary "because we are working on it. Please be patient rather than reverting. Work with us - not against us please!" Tylas, I am part of that "we". The controversy is a very notable part of DID, probably far better known to most clinicians than the specifics of treatment. The body still contains considerable discussion of the controversy, and the lead should summarize the body. The version before my edits contained only two sentences on the controversy, with no indication of why DID is controversial, only that it is. The reasons can be summarized briefly, and in my opinion should be included. I'm not sure why you think my opinion should be casually discarded when it is quite in keeping with WP:LEAD. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:02, 30 July 2012 (UTC)

Reply to WLU - Yes, of course you are Sir, but you can see from the talk page that we are working in one direction, to come in and revert the work is not nice. I would very much love you to work with us and create an A WP article. ~ty (talk) 20:05, 30 July 2012 (UTC)

"Working in one direction" is not appropriate per WP:NPOV. I did not revert any work, I replaced a block of text that was inappropriately removed. An "A" or featured article will require a discussion of the controversy, including in the lead. If you can not come up with an appropriate policy or guideline-based reason for the lead to not reflect the body, then please replace it. "It's not nice" is not such a reason, particularly when I am asking civilly, and with good reason. The body and the lead should not be one-sided and should not exclude a key position and major side of the controversy. WLU (t) (c) Wikipedia's rules:^simple/_complex 20:11, 30 July 2012 (UTC)

Reply to WLU - Perhaps I misunderstand, but I thought those that are here to peer review decided the controversy will go into once paragraph and one of them placed it. I would that that is the direction. I do however disagree strongly with your reasons. I offer my apology if I am wrong and wait to see what those who are reviewing the article report.~ty (talk) 20:17, 30 July 2012 (UTC)

Has anyone put in a request for a peer review? Doc James and Mathew Townsend are here as editors, not as peer reviewers. Why do you disagree with my reasons? WLU (t) (c) Wikipedia's rules:^simple/_complex 20:26, 30 July 2012 (UTC)

The top of the article says the article IS currently being peer reviewed. ~ty (talk) 20:31, 30 July 2012 (UTC)

I submitted it for peer review a few days ago. But I'm not sure how peer review works. The directions said it might take a while. MathewTownsend (talk) 20:38, 30 July 2012 (UTC)

The top of the talk page says to start a peer review, click on one of the hyperlinks. But primarily, the fact that a page may be peer reviewed isn't a justification for removing an edit which I can only see as appropriate per WP:LEAD. I am aware of no policy or guideline that says a page should omit a significant controversy from the lead while under peer review, and you still haven't answered my question - why do you disagree with my reasoning about leaving the controversy text in the lead? I am asking civily and politely, please do me the courtesy of responding, or admit you don't have such a reason (and in that case - please replace the text). WLU (t) (c) Wikipedia's rules:^simple/_complex 20:55, 30 July 2012 (UTC)

Reply to WLU: The group here agreed to work on the body for now, then work on the lead. If we are going to work on the lead, then I too will start debating what should and should not go there. Is this where we want to go group, or should we stick to working on the body for now?~ty (talk) 21:02, 30 July 2012 (UTC)

(edit conflict)

sorry, WLU, not sure what you are saying. There is a misunderstanding. Nothing in the article has been removed/added/changed because of the peer review. I started it to seek feedback from the people who do peer reviews. As you can see from the peer review page Wikipedia:Peer review/Dissociative identity disorder/archive1, there's been no responses. And I really don't expect any, given the topic. MathewTownsend (talk) 21:12, 30 July 2012 (UTC)

ps I think the peer reviewers won't edit the article. They'll leave suggestions/criticisms etc. on the peer review page linked above. MathewTownsend (talk) 23:03, 30 July 2012 (UTC)

Tylas, that is not a valid objection, the material I am putting in the lead is already in the body.

Mathew, my comment was directed at Tylas. I don't know how peer review works, but throwing it directly into an archive seem standard - probably need to wait a bit before someone looks over it. WLU (t) (c) Wikipedia's rules:^simple/_complex 23:15, 30 July 2012 (UTC)

Probably be a good idea to hold off on peer review for a bite until the article has advanced some. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 23:55, 30 July 2012 (UTC)

Yes, strongly agree. At the rate things are going, the version they start reading will be different from the version that exists by the time they finish :( WLU (t) (c) Wikipedia's rules:^simple/_complex 03:35, 31 July 2012 (UTC)

Removing well supported content

I am unsure why this well supported content was removed? [4] and [5] One set of text was supported by major textbooks and the other by a 2011 review article (PMID:2182904) Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 20:51, 30 July 2012 (UTC)

Reply to Doc James - Did I do it? I moved a small amount of text from under Controversy because it seemed that WLU was complaining that there was still controversy in the article as a reason to put it back in the lead. Did I mess up? If so, I am sorry. I did not mean to do anything wrong! It was suppose to go to the bottom of the page with other text moved for the same reason, but with all the editing one part did not make it there.~ty (talk) 20:56, 30 July 2012 (UTC)

Per WP:STRUCTURE we should be locating it in the appropriate section of the page, not moving it to the bottom. At some point everyone will have to discuss the whether it is appropriate to have a controversy section at all, or whether to interstitch it throughout the article. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:01, 30 July 2012 (UTC)

If we where to move everything that was controversial to the bottom the whole article would be there by the looks of it :-) If it is well supported by the evidence it should be in the body of the text. If the controversy is legal in nature or involves social groups than it should occur at the bottom. My position anyway. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 21:14, 30 July 2012 (UTC)

Still a bit confusing, but I think see what you are getting at. Then the only controversy that should be in the body is therapist induced and that is not controversy. It is accepted. Is there anything else that is not social or legal that is controversial other than if someone watched a TV show or not?~ty (talk) 21:29, 30 July 2012 (UTC)

The division between "controversial" and "not" is arbitrary and somewhat false; editors consider points controversial, pages should include the full debate. Any place a recent reliable source indicates debate or controversy should note it as appropriate, that includes treatment, etiology, diagnosis, etc. One of the problems with going to the J Trauma Dissociation is that it's specifically from a traumatology perspective; note that most of the articles in that journal ignore the controversy, while sources found elsewhere discuss it with varying degrees of detail. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:44, 30 July 2012 (UTC)

Cherry picking references: When writing about a subject one wants the work of experts. The majority of experts work on trauma research because that is where mainstream science believes we should be working and those researchers publish in a variety of journals including the one that you want ousted. To remove one journal, is like saying we need to reject all the article written with the point of view of iatrogenisis because that's all they study or they don't believe that child abuse has anything to do with having a dissociative disorder. You can't just cut out progress like that.~ty (talk) 23:25, 30 July 2012 (UTC)

So all the people who write and publish about the iatrogenic/sociocognitive position in well-respected peer reviewed journals are not experts?

I've never asked for J Trauma Dissociation to be excluded. WLU (t) (c) Wikipedia's rules:^simple/_complex 23:34, 30 July 2012 (UTC)

Yes, you have asked for that journal to be excluded before. It was just not today.~ty (talk) 23:45, 30 July 2012 (UTC)

I never said they were not expert. I am sure they are on what they do study, but the paper by Kluft (or was it Ross) pointing out problems with the research does stick in my mind, but it's not up to me. I am not an expert and I don't pick and choose. In the academic world there are certain names that come up as being considered experts, but they are not my list - they are a list by others that are qualified to say who is an expert and who is not. ~ty (talk) 23:45, 30 July 2012 (UTC)

If we simple use recent secondary sources and give similar weight that they give we should be good. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 23:53, 30 July 2012 (UTC)

Please do not put words into my mouth. I may have urged caution in the past, I very much doubt that I ever said it could not be cited. In particular, I am not saying it now. While J Trauma Dissociation is definitely a source for the traumagenic position, for much of the rest of the article, particularly the controversies, I think we'll need to look into other journals as well.

The threshold for citation is publication venue. That means university or scholarly press books, and peer-reviewed secondary sources. There's no magic list we can draw upon for who is correct to cite and who is not. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:08, 31 July 2012 (UTC)

Long and Boorish

What somehow appeared in the lede today: It became a popular diagnosis in the 1970s but it is unclear if the actual incidence of the disorder increased or only its popularity. An alternative hypotheses for its etiology is that DID is a product of techniques employed by some therapists and disagreements between the two positions is characterized by bitter debate.[11][12][13][14][3][15] Critics of the diagnosis point to characteristics such as the rareness of the diagnosis before 1980, the lack of children with DID, vagueness of the diagnostic criteria and terminology, changes in the number and forms of patient alters and the clustering of the diagnosis around certain clinical groups as evidence that the condition is due to social role-play rather than a true mental illness.[15][16]

This is a mess, a long paragraph with [11][12][13][14][3][15] all this to try and give credit to one sentence. The problem is that probably most of this stuff was taken out of context. If you are going to say there is "bitter debate" then you need to say about what exactly, not just give a long list of papers that might have similar words, that actually mean totally different than what you are implying. The Text book Doc James posted answers all these claims (I think all quite actually), but to go back and forth on all this would make the article long and boorish and still never tell people what DID is. This is just old boring stuff. What is interesting is what is real and now understood.

Critics of the diagnosis point to characteristics such as the rareness of the diagnosis before 1980, the lack of children with DID, vagueness of the diagnostic criteria and terminology, changes in the number and forms of patient alters and the clustering of the diagnosis around certain clinical groups as evidence that the condition is due to social role-play rather than a true mental illness.[15][16] This is just more of the same~ty (talk) 23:41, 30 July 2012 (UTC)

• See Citation overkill and other related articles.

While adding footnotes is helpful, adding too many can cause citation clutter, which can make articles look untidy in read mode, and unreadable in edit mode. If a page has extra citations that are either mirror pages or just parrot the other sources, they contribute nothing to its reliability while acting as a detriment to its readability. One cause of "citation overkill" is edit warring, which can lead to examples such as "Garphism is the study[1][2][3][4][5] of ...". Extreme cases have seen fifteen or more footnotes after a single word, as an editor desperately tries to shore up his point and/or overall notability of the subject with extra citations, in the hope that his opponents will accept that there are reliable sources for his edit.

One cause of "citation overkill" is edit warring, which can lead to examples such as "Garphism is the study[1][2][3][4][5] of ...".

• Ironically, excessive use of citations has the effect of decreasing credibility rather than increasing it! I advise we use a few, well chosen, reliable sources to support our statements. MathewTownsend (talk) 23:58, 30 July 2012 (UTC)

  Agree one or at most two good citations is all you need to support something.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 00:08, 31 July 2012 (UTC)

Reduced to two citations is fine, I've also tried to shorten the explanation and added Cardena's alternative explanation (lack of training of clinicians to recognize the diagnosis. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:45, 31 July 2012 (UTC)

Great Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 00:48, 31 July 2012 (UTC)

I agree there were more citations than necessary. Ideally we don't need any, because the lead summarizes the article, and the article has them, but historically a number of people tried to argue that there were no reliable sources for those statements and insisted on citations on the lead, and it all exploded from there. It looks like this change has broad consensus, so that one should be done. DreamGuy (talk) 02:20, 31 July 2012 (UTC)

I have tried at one point in time to follow the rule of "lead does not need referencing" in some of the good articles I was writing. Readers just continually come along and add ^{[CS Ch.{{{ch}}}]} template. Thus I have given up. Are readers expect citations and do not want to have to read the body of the text to find them. This is one of the rules that deserves ignoring. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 03:23, 31 July 2012 (UTC)

Someone has updated the recommendations on citations in the lead to mach with reality :-) [6] Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 03:27, 31 July 2012 (UTC)

I managed it once, and once only, on Bioidentical hormone replacement therapy. And still some filthy mucker slipped one in, where it stands out like a severed thumb in a pasta salad :) WLU (t) (c) Wikipedia's rules:^simple/_complex 03:34, 31 July 2012 (UTC)

Signs and Symptoms

I noticed in the signs and symptoms section this was written: "Despite research on DID including structural and functional magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, event-related potential and electroencephalography, no convergent neuroimaging findings have been identified regarding DID..."

But then the last sentence of the same paragraph states, "DID patients may also demonstrate altered neuroanatomy."

This seems confusing and contradictory to me.

(Sorry if I'm just misunderstanding or going about things the wrong way; I'm new here.) Dirajero (talk) 00:24, 31 July 2012 (UTC)

Good catch and welcome to the DID article. :) ~ty (talk) 00:41, 31 July 2012 (UTC)

And these are not really signs or symptoms so moved to a section on "pathophysiology" Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 00:50, 31 July 2012 (UTC)

Lots of good work on the page today Doc and Mathew!~ty (talk) 01:26, 31 July 2012 (UTC)

Stop making controversial changes without consensus

Everyone is talking every which way and making large numbers of edits to the article, and very few of these changes are being discussed. Even fewer are receiving anything like a wide agreement.

On controversial topics, the goal of NPOV policy is not that everyone is happy, but that everyone (or as many people as possible) agree that the wording that exists is fair and accurate. Many of the recent edits have been in areas that anyone looking at this topic page would know were already discussed as unfairly slanted and inaccurate. We all know this is a very controversial article. Nobody can in good conscience ignore that. To ignore that and rush ahead suggests you are not interested in working with others. It shows bad faith in your edits here. I know people are emotional, but everyone needs to follow our policies. I can understand why newbies might make this mistake, but for editors who have been around a long time it's incomprehensible.

Per WP:BRD, I have reverted to the last stable version. DocJames above said I had every right to do so in this situation, so I did. This version is the version closest to the one that had consensus for many months here, other than a few changes made to fit what everyone I've seen so far agreed on (removing mention of Sybil, though I did so reluctantly until we have better wording we can agree upon) DreamGuy (talk) 02:17, 31 July 2012 (UTC)

Tylas reverted, and this is one case where I agree. Many of the improvements your revert over-wrote were in my opinion (and in the opinions of Tylas, Doc James and Mathew since none reverted them) good ones. The version that was stable for so long is obviously not acceptable to many people, and while I do think there was obvious consensus that Tylas' hundreds of edits resulted in a poorer page, I don't think that means we should preserve the old version indefinitely. Many of the changes were citation improvements, removal of older or primary articles, and the use of respected textbooks. These are changes I think worth keeping. I don't think a neutral page means portraying the traumagenic position as wrong, any more than portraying the iatrogenic position as wrong. As much as Tylas' edits go too far towards the traumagenic position, I think your edits go too far in the opposite direction. WLU (t) (c) Wikipedia's rules:^simple/_complex 03:01, 31 July 2012 (UTC)

It doesn't have to be indefinitely, but we don't need a massive change immediately either. Every policy that mentions these situations say consensus first, and we don't have that, not by a long shot. If you think there are changes we can agree on, like the paring down of citatons in the lead, then we can discuss those individually and make just those changes. But completely changing the wording of the lead, deleting stuff and so forth is completely unacceptable without prior discussion and consensus. Period. And it's a shame I'm the only one who gets that. If you think my edits go too far, please explain why, because I do not see you commenting on any of that on this talk page. DreamGuy (talk) 03:11, 31 July 2012 (UTC)

Well, that didn't last long. At this point there are three or four completely different versions people are reverting to. Nobody can agree which of these directions to go, so why do people think they are justified in moving forward? This unfortunately means we have to move onto something a little stronger...DreamGuy (talk) 03:05, 31 July 2012 (UTC)

One does not typically need consensus to replace primary sources with secondary ones. As consensus is that this is what we should be doing. If you see content that was removed and supported by secondary sources which you feel should not have been removed. You may return it. But removing all the new secondary sourcing is not the best form. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 03:19, 31 July 2012 (UTC)

I think this page in general needs a solid updating. The top section of the page is a sorted-by-year list of sources on DID, many of which are less than 5 years old (though I believe I put that list together looking for sources specifically on the iatrogenesis model, to illustrate that it was indeed still a large concern in DID research). My e-mail inbox has eight articles from 2012, and another eight from 2011 that could be integrated. The last time this page got a good top-to-bottom reworking was, I believe, when ResearchEditor was around in 2007(!) and a lot has happened since then. I plan on adding as many of the new sources I can over the next couple days, and I don't think this is an approach that can be argued with. From there, it would probably be a good idea to scrub out many of the older ones. Can we agree, in principle, on such an approach? Focus on finding and integrating sources between 2008 and 2012 and bringing the page up to date?

My greater concern with the page is that it's quite long, and the sections are splintering, overlapping and generally needs what I would characterizes as a good combing. So many editors working simultaneously is contributing to this, but frankly I don't have a solution. WLU (t) (c) Wikipedia's rules:^simple/_complex 03:31, 31 July 2012 (UTC)

Useful to add an exact quote to the citation template to support your paraphrasing. Makes thing easier to verify.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 03:33, 31 July 2012 (UTC)

Notice here where Doc James suggests using a quote in citations.~ty (talk) 00:14, 1 August 2012 (UTC)

to WLU - interesting addition!

Your latest addition ("Disturbed and altered sleep has also been suggested as having a role in dissociative disorders in general and DID in specific." is very interesting. Now that I've been looking at the recent literature, I see that the research has turned toward examining the memory functioning from a neurological view, examining avenues like altered sleep etc. Since psychiatry in general is leaning more toward genetic and neurobiological influences, it makes sense that if the field would drop this dichotomy of real versus play acting and start actually examining what is going on, it could get really interesting! Thanks! MathewTownsend (talk) 02:36, 31 July 2012 (UTC)

I got that paper from one of the authors, if you e-mail them, you can probably get a free copy. Disappointingly (for this page), it focuses on dissociation in general rather than DID in particular and that's about all the milking I can get from it for this page. You might be interested in Lynn, 2012 (DOI 10.1177/0963721411429457) which has more on experimental tests of memory, the iatrogenic/sociocognitive position, and experimental stuff (again, requested from the author). Very recent, but also pretty one-sided... WLU (t) (c) Wikipedia's rules:^simple/_complex 02:52, 31 July 2012 (UTC)

Here's a previewable google book that that goes into some of these features as well [7]. It's weird how there really do seem to be two camps and ne'er the 'twain shall meet. WLU (t) (c) Wikipedia's rules:^simple/_complex 03:03, 31 July 2012 (UTC)

(edit conflict)

Plus it makes sense since suggestibility is so prominent in DID that there are several reveiw articles on the effectiveness of using these methods and others. e.g. Cognitive behavioral hypnotherapy for dissociative disorders., Memory in dreams, Memory in dreams., Integrative psychotherapy: combining ego-state therapy, clinical hypnosis, and eye movement desensitization and reprocessing (EMDR) in a psychosocial developmental context (a little old - 2001), Cognitive behavioral hypnotherapy for dissociative disorders. 2012, Dissociation and memory fragmentation in post-traumatic stress disorder: an evaluation of the dissociative encoding hypothesis. 2012. etc. (I just grabbed a few, but these seems to be increasing evidence linking (or relating) PTSD with dissociative disorder. (Don't want you to think I'm flaky - I'm just staying up very late to watch the Olympics!) MathewTownsend (talk) 03:14, 31 July 2012 (UTC)

Ugh, am I the only one who hates EMDR and thinks it's pretty rank quackery?

You should read Lynn 2012, you'll find it very interesting I think. It's also a great updating of the iatrogenic/SC position, suggesting lines of evidence I hadn't seen before (including the sleep one). WLU (t) (c) Wikipedia's rules:^simple/_complex 03:20, 31 July 2012 (UTC)

Oh, I agree about EMDR. But I had a neurophysiology prof in graduate school who said that if acupuncture had any effectiveness then he would have to throw out everything he knew about neurophysiology. Well ... MathewTownsend (talk) 03:32, 31 July 2012 (UTC)

Acupuncture works, it's pretty good at reducing pain and nausea. Whether that is due to specific effects, or merely because it is an unusually potent placebo is still being debated. Amusingly, when a study finds acupuncture and placebo acupuncture are both equally better at relieving pain and nausea than no treatment, proponents proclaim that means acupuncture works. I wonder how the FDA would respond if Pfizer said "our drug is as effective as placebo, compared to waiting list controls" during a drug application. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:57, 31 July 2012 (UTC)

Pathophysiology

This is a great new section. I am going to do some more reading on this. Thanks to whoever added it!~ty (talk) 00:22, 1 August 2012 (UTC)

To Tylas - there's no hurry!

Wikipedia has no deadline per WP:NODEADLINE. No one person should write this article and no one should be making big changes in one day. This article is a collaboration. Many of your problems come from doing too much too fast. Slow down! This article is about a diagnosis, not about anyone's personal experience. MathewTownsend (talk) 01:11, 1 August 2012 (UTC)

But all I did was the prognosis section that Doc James asked me to do. It was a short little thing. I have not been working on anything else. I don't understand?~ty (talk) 01:29, 1 August 2012 (UTC)

I can slow down. I did not want to disappoint anyone here who is working hard and not do my part. I felt really bad I did not get more of that section done last night, so I hit it hard all day today. I will keep working on prognosis. okay? It still needs a lot of work. :) ~ty (talk) 07:56, 1 August 2012 (UTC)

re "shame"

Under "Signs and symptoms" where it says: "The majority of patients with DID report a history of abuse, both sexual and physical during their childhood." I edited out the phrase "resulting in feelings of shame and fear that might inhibit reporting symptoms." This is no different from any individuals who have a "history of abuse, both sexual and physical during their childhood", so this is not characteristic of those diagnosed with DID. I hesitated about the inclusion of "Individuals with DID may experience distress from the consequences of DID rather than from the symptoms themselves." It is cited to an article recommending future directions for DSM-V - but since I don't have access to the whole article, I don't know what empirical evidence Spiegel is basing this on. MathewTownsend (talk) 23:43, 1 August 2012 (UTC)

This is from the book that Doc suggested we use I believe. Guilt and shame. Quite a topic in itself! I will see if I can find the exact location for you. Just a thought - keep in mind that those who have DID were usually severely abused. They have parts of the self that exist that are saturated with those feeling - not to discount the abuse of ANY child!~ty (talk) 23:50, 1 August 2012 (UTC)

Hales-prognosis - quote=Furthermore, because most patients with DID report histories of sexual and physical abuse, the shame associated with that experience, as well as fear of retribution, may inhibit reporting of symptoms.

See page 683 - under the title "Course" on the right side of the page - it is a little less than halfway down that column. Also I have no idea why it has a citation of Spiegel. I did not do that. ~ty (talk) 00:09, 2 August 2012 (UTC)

• You have to use judgment. Just because it comes out of a book, does it make sense that the "shame" etc. is characteristic of those diagnosed with DID, more so than others with similar histories? Or is the book writer suggesting that it is diagnostic of DID that they experience so much more "shame" etc. than the others with similar histories? Or what? What is the point of adding a well known fact characteristic of persons who were abused as children to the "Signs and symptoms" of DID? MathewTownsend (talk) 00:23, 2 August 2012 (UTC)

I do not argue deleting it. I do however believe it does make sense. Other victims of child sexual abuse will feel shame of course! - but they do not have dissociated parts, that can totally take over and refuse to be subjected to shame -keeping in mind the ANP does not even know of the abuse normally. I know it does not make sense unless you have lived it or worked with those that have it, but these parts come out and take over stopping many such actions as going to therapy. For many with DID, finally asking for help is one of the hardest things they will ever do in their life. Either way you choose is fine with me. It is not something that needs to be in the article at all.~ty (talk) 00:29, 2 August 2012 (UTC)

Also, I don't think it was me that put it there. I had some of that text under prognosis, but did not add anything to the signs and symptoms that I remember or can find. It might have been me, but I don't think so. I never say never though!~ty (talk) 00:32, 2 August 2012 (UTC)

(edit conflict)

But Hale says that most are amnesiac for the physical/sexual abuse. So if they don't remember it then of course they're not going to report it. Also, he is speaking about data from specific samples.

Yes, the host at the time in life will not remember the event, most of the time, but other parts of the self do. It depends on who is out and doing the talking.~ty (talk) 00:46, 2 August 2012 (UTC)

What about my comment above: "Individuals with DID may experience distress from the consequences of DID rather than from the symptoms themselves." It is cited to an article recommending future directions for DSM-V - but since I don't have access to the whole article, I don't know what empirical evidence Spiegel is basing this on." Are you saying it's true but not from Speigel? From some other source? (I don't see it on the page - half way down on page 683 as you reference). Can you clarify? MathewTownsend (talk) 00:39, 2 August 2012 (UTC)

Please stop adding quotes

If you don't know how to add a quote to a citation template, ask. I don't see the need for a large number of quotes anyway, the points that are having quotes added to them are not being challenged that I can see, nor are they so fine or nuanced that they need a direct quotation to avoid misrepresentation. Quotes add to the length of the page (and the page is already quite long), and for the most part do not add to the interpretation. If the text says "DID rarely if ever goes away without treatment", I do not see a need for a quote saying "but dissociative identity disorder does not resolve spontaneously". WLU (t) (c) Wikipedia's rules:^simple/_complex 21:54, 31 July 2012 (UTC)

I did ask Mathew. He is easy to work with. Also easy to work with is Doc James, who contrary to you, would like the quotes added. I never know which points will be challenged Sir. I have found this to be a wonderful process and I quite like it. It does bring credibility to each statement. Oh sorry, that I put in the credits you respect Doc James. I don't mean to put words in your mouth! Forgive me! I was not thinking and can't remove it. ~ty (talk) 22:02, 31 July 2012 (UTC)

Notice how I don't talk about whether I think you are hard to work with? Please do me the same courtesy.

You asked why I did not ask. I did, I just did not ask you. It was a simple statement Sir.~ty (talk) 00:08, 1 August 2012 (UTC)

Basic information, like that found in the Merck manual, is not likely to be challenged and does not need a quote. I can't think of an instance where a quote would resolve an issue, they are generally about weight and rarely specific sources. I see quotes only useful when one editor challenges the summary of another, on a source both agree to use. I can't remember an instance of that happening on this page. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:29, 31 July 2012 (UTC)

Some of the quote didn't actually match the text. For instance, the text said

Patients are often hesitant to complete psychotherapy due to fear and shame from the abuse suffered in their childhood

but the book quote was:

Furthermore, because most patients with DID report histories of sexual and physical abuse, the shame associated with that experience, as well as fear of retribution, may inhibit reporting of symptoms

I will make it closer to the original quote and add more original quote so the meaning is more clear. I debated, but did not want to make the quotes too long Sir.~ty (talk) 00:10, 1 August 2012 (UTC)

Reporting symptoms isn't the same thing as completing therapy. Also consider from the text:

Resolution of symptoms of DID is important to more than just the DID patient but to the well-being of off-spring as well. Parenting is quite difficult for the person with DID, even though it might not be obvious to them, severe dissociation and other actions affects their children

Yeah, that can be taken out. I debated, but many with DID do finally give in and get help just for their kids when they will not for themselves.~ty (talk) 00:12, 1 August 2012 (UTC)

Compared to the actual citation:

One last consequence of DID is the subject's inability to be adequate parents, at least while symptomatic

If quotes are being used, even if they aren't, it is important to stick close to what the source actually says, not extrapolations. WLU (t) (c) Wikipedia's rules:^simple/_complex 23:22, 31 July 2012 (UTC)

I will go back through these and see one by one and copy the text even closer, but I will use common terminology used when talking about DID.00:08, 1 August 2012 (UTC)

I agree with WLU. Quotes are not needed, indeed they clutter the text, unless it is an unusual or unlikely statement. Also, it's not good to cite the same source over and over per WP:UNDUE. No one authority needs to be used as a source more than a few times. MathewTownsend (talk) 00:18, 1 August 2012 (UTC)

ps A quote means using the exact wording of the source. That's what a quote is. If you rephrase it, it's not a quote. MathewTownsend (talk) 00:20, 1 August 2012 (UTC)

Reply to Mathew - I am trying to do as Doc James suggested, but Mathew I also respect you and would like to do what is WP correct and respect the opinions of both of you on this. Doc said to stick to grad school level texts for now and sources like the merk manual. I would love to use the multitude of books and journal articles that I have, but for now he said to start with this. I can certainly add the others to this! Can we have him explain why? I assume this is to stop much of the controversy. This is a time consuming process, but if it is what is needed, I can do it.

Question for WLU and DG - without the quotes there would you 2 delete anything from the prognosis section that is there? Understanding that I will make those things WLU addressed above closer to the actual quote? ~ty (talk) 00:30, 1 August 2012 (UTC)

Question for All - I fixed what WLU suggested. I see WLU fixed some citation errors with spelling of merkdoc - I was about to do that, but thank you. Is there anything else in the prognosis section any of you would like me to look at? I am not done with it by the way. I just had to go for a while.~ty (talk) 00:58, 1 August 2012 (UTC)

There's nothing wrong with noting that parenting is difficult for DID patients if the source actually says this.

The prognosis section is long, and mostly sourced to Merck - which if you look at the bottom of that page, was last updated in 2008. And further, comparing the prognosis section to the Merck page used to verify, there is a large section of text that doesn't seem to match what is said on the Merck page.

Overall, I simply think the prognosis section needs better sources. Merck is OK, but now old. I'm sure there's other, more recent sources that could be tapped. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:11, 1 August 2012 (UTC)

Okay, please don't delete what is there however. Let me know on this talk page and I will work on it. I keep getting different opinions from you, Mathew and Doc. I am going to wait and see what Doc and Mathew say about this if you don't mind. It is a group effort. I do have so many sources, but am doing what Doc James suggested.~ty (talk) 01:32, 1 August 2012 (UTC)

Also if something belongs in therapy, please let me know so I can weigh in on it as well, and if it goes there then it can be moved - not deleted please.~ty (talk) 01:33, 1 August 2012 (UTC)

Nothing is ever lost, anything removed is in the page history. However, you should not be replacing something in the prognosis section because it was once on the page. You should only add things to the prognosis section if they can be verified by reliable sources. Sources are not an excuse or hurdle you need to put in something you think should be there - sources are the threshold that must be passed for any material to be included. Pages are based on sources, not on editor opinion. Hales has a section on prognosis (though they call it "Course"), that is another source besides Merck to draw upon. Your time might be better spent looking for multiple sources that discuss prognosis, reading them all carefully and then trying to draw out the common themes. It looks like there's not much on prognosis out there, and this is backed up by other sources that discuss the lack of controlled clinical trials for patients. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:15, 1 August 2012 (UTC)

Please Tylas, the prognosis section is not solely your responsibility. Best to add a little now and then per day, while keeping the balance of the entire article in mind. Then reflect on the whole and read more sources. IMO, there isn't a whole lot to say about prognosis as there are few reliable secondary sources that address the subject, especially review articles. For example, the statement: "Prognosis can be excellent; case studies report that most cases of DID resolve with proper therapy, but there are no controlled trials." This sentence gives us little useful information as case studies by their nature are not valid for outcome statements. And they are usually written by proponents of the therapy who are going to report favorable outcomes and therefore are not NPOV. No controlled trials means we have no information on prognosis. MathewTownsend (talk) 13:25, 1 August 2012 (UTC)

Reply to Mathew - Good morning Sir and I am sorry this is so long, but there is a lot to say! First I applaud all your work on the DID page, as well as Doc James. I know it's not an easy page to work on! Second, I have no problem with the actual facts about iatrogenesis and agree with those actual facts, but I want to reflect current research and knowledge on the entire page, not a biased POV - what that balance is appears to be a problem on WP, but it is not in the mainstream academic and research world as is clearly shown in the grad level text book - Hales. I would happily work on the iatrogenic section and you would see that I am not biased, but that is a controversial section so I stay clear of it as much as possible. I do "feel" (which is a bad word to use, but appropriate here) that I need to defend my actions, taking into account that I am so far from perfect it's silly, but I am trying my best! Of course the few lines on the prognosis section that were there when I was given the task to work on by editor Doc James (more lines now than a few days ago) are not my entire responsibility and I don't want them to be, but at the same time WLU should not come in and simply delete that work either that I spent the entire day yesterday working on, following methods I was directed to use. If parts of the text belong under therapy, then they should be moved there, not deleted. Each line was carefully paraphrased from direct quotes that were given in the citations. WLU had some complaints, so I tried my best to fix what he saw as problems. We should discuss such things here on the page. right? It gets confusing to newer editors, like me, when things just disappear almost as soon as they are posted. I want help, and am trying my best to address all the problems brought up. I see changes in the prognosis section and that's great - really awesome even, but just reverting or deleting as WLU often tends (no offense Sir, just stating things I have understood them to be and I could be wrong. I am not trying to attack you, but to understand this process) is a problem - at least how I interpret it. Then I learn this method by watching him and am jumped on by him if I delete something of his. It gets confusing to say the least! As for reading more sources, I think I have read all the sources on the page (although I see a new section that I have never looked into, but I am afraid to spend time there since I think WLU wants that section removed. I have not paid a lot of attention to that, so don't quote me on this.) Other than finding some text books when I get to a town, there is not a bunch more out. I do have many, very current books that go beyond grad level texts, however that I would love to use but I am trying to do as Doc directed me to as in which references to use first - then I was planning to add others since I think this was his meaning (but I could be wrong). I have had trouble finding much about prognosis too. Most of what is in that paragraph on prognosis was already there and probably written by WLU, and I started to work with that text. Most of the section was already paraphrased from Merck before I started - if I remember right, but it's hard to know for certain with all the total page versions and reverts. I was asked by Doc James to focus on the prognosis section, so I did. I feel like a puppet being pulled in all directions. I want to do the right thing, but it seems on WP there is no such thing, since each editor has different views of the rules and guidelines, but, I can roll with the punches. I do try and do as both you, Mathew and Doc James direct me to because, so far from what I have seen, you and Doc are both unbiased and totally respectable editors, who have advanced knowledge of WP. You seem to know your psychology and Doc knows medicine. I think it's a great balance. As far as the prognosis section, I did do all the work in my sandbox and then asked everyone here to please look at it there and give suggestions (I even posted it on the talk page) - none were given other than Doc James, who asked me to add direct quotes to each statement, so I did - that was new to me, so I added a little at a time to the DID page in my best attempt to not mess things up as far as WP formatting, citations, etc. I am not an expert WP person, and I humbly bow to that and LOVE direction by kind, knowledgeable editors such as yourself and Doc. I have read a great (not the pop culture - I avoid that as much as possible) deal about DID and should be allowed to work here, no matter what the edits show, I actually have few on the page compared to WLU. We have to keep in mind that the "whole" of the page was a personal copy written and edited almost solely by WLU and kept in his own sandbox then put here all at once. This is the version we began with a few days ago. Which means that WLU has written almost the entire DID page himself. It's confusing that I cannot work on a small section, with that in mind. AS for clinical studies, I can post here the reasons why there are not clinical studies (but I am sure you know) and I have no disagreement to that sentence of the paragraph being deleted? I would have exaggerated on why there is a lack of clinical DID studies in that line, but I was trying to keep it brief. One last note or question - it is is better that I read through the entire article and make small changes here and there - that is the sort of thing I LOVE to do!!!!! I would be so happy to do that instead of be limited to a small section. Let me know. Until then, my plan for the day is to work on references and clean up the prognosis section and address any concerns others have about it. I enjoy teamwork and don't want to be out here working on the article alone! In fact, I would dread that! :) ~ty (talk) 15:21, 1 August 2012 (UTC)

reply to Tylas

A good way to start is to read the article and make little copy editing changes, like spelling etc. Then, since this is a controversial article, why don't you discuss any proposed changes on the talk page first. Then, make a few small changes and see how they are received by other editors. No one should be putting such a large amount of text that if it's deleted they can't handle it. (And remember, anything you write is still in the article history and can be retrieved.) If someone makes a deletion you disagree with, take it to the talk page and discuss it. Remember, other editors, like WLU, have worked long and hard on this page over a period of years so think how they are going to react when you make many major changes to the article without consulting others in a few days. MathewTownsend (talk) 16:13, 1 August 2012 (UTC)

Reply to Mathew - Of course I can do that, but have tried this before and even my smallest edits were reverted and never agreed to. But now there are some new editors here, that just might work! Good suggestion! You are very helpful Sir! Thank you! I so want the group to be able to make progress on the DID article and I want to be a helper, not a problem! Keep setting me straight. I appreciate it!~ty (talk) 16:49, 1 August 2012 (UTC)

If your edits insert text that is not verified by sources, in particular if it is not verified by the source attached to it, I very much should remove it, not move it to a different section. WP:V is a core content policy, and should not be ignored.

Hales is not the only source, and many other sources newer than 2008 indicate DID is still controversial.

It may be harsh, but competence is required; you would almost certainly do better on this page if you spent more time working on other pages, then returned with a better understanding of wikipedia based on topics you are not so personally invested in. Edits are problematic depending on whether they comply with policies and guidelines, and whether they misrepresent sources. Based on my reading of the quote given and the text attached, the sources were being misrepresented. The best of intentions doesn't change the fact that the sources were made to say something other than what they actually said.

"Unbiased" doesn't mean "someone who agrees with me". Bias always refers to our policy on reliable sources and neutrality, and neutrality is determined by weight and volume of sources.

Your summary of the version stored in my sandbox is incorrect. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:24, 2 August 2012 (UTC)

Here is an example of something I consider problematic. In this edit Tylas changed the text from "DID may be the result of role-playing rather than separate personalities, though others disagree, pointing to a lack of incentive to manufacture or maintain separate personalities" to "DID may be the result of role-playing rather than separate parts of a personality, though others disagree, pointing to a lack of incentive to manufacture or maintain separate personality states" with an edit summary "parts of the personality - there is no such thing as multiple personalities". The actual source does not say "parts" or "personality states", it specifies separate personalities. This is an edit that is problematic because the editor in question has an opinion about the subject matter, and alters the wikipedia page to conform to their personal opinion rather than what the source actually verifies. This is a case where a direct quote might be helpful, but not near so helpful as Tylas abandoning the practice of editing the page to conform to their idea of what is "real" DID and instead editing according to the actual sources. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:45, 2 August 2012 (UTC)

Reply - I agree with Mathew and think that using "personality states" solves all problems. Knowing what a personality is from a personality state is not an opinion.~ty (talk) 21:46, 2 August 2012 (UTC)

Using the word "personality" simply continues to confuse people about not only DID, but basic psychology. I refer you back to my section titled Psychology 101 which explains this. I will look for it on the talk page. It might have been archived. 21:42, 2 August 2012 (UTC)~ty (talk) 21:46, 2 August 2012 (UTC)

I can't find it even in the archives so I added a new section to explain why I think this is very important. It's under "personality confusion."~ty (talk) 22:11, 2 August 2012 (UTC)

Proposed changes for the DSM-V

"Despite the lengthy history of the psychopathology of dissociative disorders, and the intense study by Pierre Janet in the first part of the last century and by Jean-Martin Charcot before him, dissociative disorders have been largely disregarded since Freud and have not received serious attention again until recently.[45] Prior versions of DSM have avoided consideration of etiology in an effort to distance itself from Freudian psychology. DSM-V is attempting to reintroduce etiology; and the "development of a pathophysiologically based classification system" has been advocated such as investigation of the neuroevolution of "stress-induced and fear circuitry disorders and related amygdala-driven, species-atypical fear behaviors of clinical severity in adult humans."[46]"

I just read this. Wow! Now that is someone that understands what is going on both with history and the DSM. Thank you to whoever did this. It's a breath of fresh air! I think advocated is spelled wrong. Will fix for you. :) ~ty (talk) 01:08, 1 August 2012 (UTC)

Ever so Bold Mathew - How about we put that section under the category of DSM history and make is DSM history and current events or something like that? :) ~ty (talk) 21:05, 2 August 2012 (UTC)

reply to Tylas

Because it hasn't happened yet and when it is published it may not reflect the published proposals. It is not part of the diagnosis now, which is what this article is about. And Casliber is a psychiatrist, and he thinks its inappropriate to include it. (And I agree with him.) He wrote Major depressive disorder which you might take a look at as a model for how an article on a psychiatric diagnosis should be formatted. MathewTownsend (talk) 21:33, 2 August 2012 (UTC)

:Reply to Mathew - I can understand that and thought it would be the cause, but thought I should ask so the question did not sit in my head. Thanks. :) ~ty (talk) 21:43, 2 August 2012 (UTC)

Signs and Symptoms

Sorry, missed that! Thanks for pointing me to it! :) I read those words in the WP article and did not know what that was suppose to mean? What is "consequences of DID?" vs "symptoms themselves?" - again I don't think I was the one that wrote this. This must have showed up yesterday in all that moving commotion going on. I only wrote in the prognosis section yesterday - I believe. I will look at the reference. I might have that book or article. The words themselves are not familiar at all to me - I don't remember reading them, but will look and see what I come up with. ~ty (talk) 00:46, 2 August 2012 (UTC)

It seems like it means that the DID person would be perfectly happy being DID, except the real world trips them up e.g. people in general become exhausted dealing with all the symptoms and don't want to deal with the person any more. They lose jobs because dysfunctional "alters" don't want to work, etc. MathewTownsend (talk) 00:59, 2 August 2012 (UTC)

I found the sentence in question. No that is not something I did.

On WP page: "Individuals with DID may experience distress from the consequences of DID rather than from the symptoms themselves.[15]"

Reference [15] is about DD in general and rec for the DSM 5.

What (Spiegel D, Loewenstein RJ, Lewis-Fernández R, Sar V, Simeon D, Vermetten E, Cardeña E, Dell PF.) say about DID in this review article is that:

• RESULTS:

3. The diagnostic criteria for DID should be changed to emphasize the disruptive nature of the dissociation and amnesia for everyday as well as traumatic events. The experience of possession should be included in the definition of identity disruption.

• CONCLUSIONS:

There is a growing body of evidence linking the dissociative disorders to a trauma history, and to specific neural mechanisms. ~ty (talk) 01:04, 2 August 2012 (UTC)

OK, that means it should not be in "Signs and symptoms" but in some section that discusses recent evidence and suggestions for changes in DSM-V! MathewTownsend (talk) 01:16, 2 August 2012 (UTC)

Agreed.~ty (talk) 01:17, 2 August 2012 (UTC)

Agreed also. Casliber (talk · contribs) 13:09, 2 August 2012 (UTC)

Dissociation

Here is a great review article on dissociation by David Spiegel MD. In the article it says there is controversy about what dissociation is. This article should help with that. ~ty (talk) 18:15, 2 August 2012 (UTC)

If it's about dissociation in general, then we would have to be very cautious about using it here on DID. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:59, 2 August 2012 (UTC)

also, it's an editorial regarding the broad concept of "dissociation" and its the future in DSM-V. Kind of off topic here. MathewTownsend (talk) 12:05, 2 August 2012 (UTC)

Final sobering point is that DSM V is by no means clear-cut as alot of psychiatrists are very unhappy about it, so I really think we need to keep away from it until it becomes official....I will try to take a look at the paper though. Casliber (talk · contribs) 12:33, 2 August 2012 (UTC)

Spiegel also says in the same source: "We are considering proposing that there be a stress and trauma spectrum section of the DSM5 that would include the adjustment disorders, acute stress disorder, posttraumatic stress disorder, and the dissociative disorders." MathewTownsend (talk) 13:06, 2 August 2012 (UTC)

I was bold and removed the DSM-V section per Casliber above. I believe there are compelling reasons not to include it, aside from the fact that it is not a final version. It only adds more complex terminology to the article without clarifying anything. MathewTownsend (talk) 19:47, 2 August 2012 (UTC)

When talking about dissociation, it is not what it is that is "not agreed upon", it's when the label is used to mean so many different things in psychology. See page 474 for a nice explanation of this. The type of dissociation that occurs in dissociative disorders is usually referred to as pathological dissociation. Perhaps using that label throughout our article would remove confusion as to what type of dissociation it is that we are talking about - every day normal dissociation or pathological dissociation. Dell explains more about dissociation here including "Even the DSM provides a descriptive account of dissocation at the psychological level." The psychological explanation of dissociation he gives is: "Chronic dissociative symptoms are manifestations of posttraumatic self states or alter personalities. (which we are using the label of "personality states." - they are all the same thing: dissociated personality states, alter, alter personalities, posttraumatic self states.)~ty (talk) 23:55, 2 August 2012 (UTC)

Archiving

Can those who have been editing please archive threads which are resolved or repeated elsewhere. Also, if good sources have been found, can someone note that they've been added. I've just started to read this talk page and am trying to figure out where to start.....Casliber (talk · contribs) 12:44, 2 August 2012 (UTC)

The next step is to look at Medical article guidelines and Good Article guidelines and see how the article squares up. I agree that Peer Review is generally a good idea, though I worry that it will fork discussion into two places.....Casliber (talk · contribs) 12:44, 2 August 2012 (UTC)

I've manually archived a bunch of stuff. Don't think I took out anything still ongoing. Also changed archive date from 30 days to 7. WLU (t) (c) Wikipedia's rules:^simple/_complex 19:23, 2 August 2012 (UTC)

Children

There is "considerable delay between initial symptoms" and the time DID "emerges." Usually DID does not "emerge" before adolescence. name=Hales-prognosis>"Course". p. 283. {{cite book}}: Missing or empty |title= (help) See the first sentence under course on page 283. Does anyone argue this change? ~ty (talk) 00:24, 2 August 2012 (UTC)

I am confused. The WP article says "To date approximately 250 cases of DID in children have been identified, though the data does not offer unequivocal support for either theory.", but the reference I look at (and I want to read the entire article, but there is only an abstract there says: "The review produced a total of 255 cases of childhood DID reported as individual case studies" The WP statement makes it sound like there have only been about 250 cases ever of diagnosed DID. Is this right? I must admit, I have not dug much into childhood DID.~ty (talk) 00:39, 2 August 2012 (UTC)

well, my opinion is that's another statement from Hale that doesn't make sense. Who knows when it "emerges" (if that is any kind of word to use!) since it isn't diagnosed until the individual has been in "treatment" for 6+ years. As far as the number of children, do you have a citation stating otherwise? Many have stated that it is quite rare in children, but I don't know what they're basing that on. I confess I've never heard of a case in children. MathewTownsend (talk) 00:45, 2 August 2012 (UTC)

I am confused again. Where does anything say that a Dx is not made until someone has been in treatment for 6+ years? It depends on if one is lucky enough to get a good therapist or not. For me the Dx was by 3 different professionals and in an extreme short period of time. Many therapists do not under DD though, and then a person with DID gets lost in the system. It's not the person with DID's fault they are misdiagnosed.~ty (talk) 00:53, 2 August 2012 (UTC)

No, my point is the study that says 255 is not saying that this is all the children that have ever been Dx'd they are saying that is the number of children in the study. right?~ty (talk) 00:53, 2 August 2012 (UTC)

Children are in the home with their abusers. Many of their dissociated parts will go to all lengths to disguise their DID from everyone. You know.. all that introject, protector DID stuff. It's so long to go into.~ty (talk) 00:53, 2 August 2012 (UTC)

If I am allowed, I can look into very recent books by Howell, Dell, etc.. and see what they say about this. I read all that Hale wrote in that book and it agrees with everything else I have read from those who are considered to be the leaders in the field of DID, but if you have not really looked into this stuff it is easy to misinterpret. For me I don't understand the normal brain. It's hard to understand why others do not understand the DID brain. Trying to imagine it only gets one so far.~ty (talk) 01:16, 2 August 2012 (UTC)

Please consider that this source your are using is relying on studies that are from the 1980s! That's not recent reliable information suitable for this article. It is out of date. MathewTownsend (talk) 01:25, 2 August 2012 (UTC)

I am not disagreeing with the 2011 review by Boysen! I am saying that what is on the WP DID page does not say what the 2011 article say, nor does it say what the text book says. Sorry I did not make that clear. I don't know how many abused children, as I stated above could get away with telling. They would probably be punished I would not expect there to be much data on children. :)

Here is the article: RESULTS:

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.

CONCLUSION:

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. ~ty (talk) 01:32, 2 August 2012 (UTC)

Case histories are the easiest to report, so the fact that only 255 case histories of childhood DID have been reported is significant, as it would be an easy publication to write up a case history of a childhood DID. MathewTownsend (talk) 01:53, 2 August 2012 (UTC)

The section on children came from Boysen, 2011, and I really don't think putting Hale in that section is appropriate - particularly since the entire section is about the emergence of DID in children and Hale isn't speaking at length, or specifically, about children and doesn't specify an age range. Boysen is saying that only about 250 cases of DID in children have been reported in the scientific literature. I believe my summary of the paper is accurate, but feel free to check it and we can discuss specific wording.

I got the article from Boysen himself, he would probably be happy to supply a reprint if either of you asked for it. I think his e-mail is reported in the abstract. It's a very interesting article. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:57, 2 August 2012 (UTC)

I just emailed him for a copy. (not completely sure if the email went through ok.) We'll see. MathewTownsend (talk) 02:07, 2 August 2012 (UTC)

O-kay - I can't see the google book pages but have a word of caution to add. One interpretation is that identities are an extreme expression of a normal human phenomenon. Children from the age of two might pretend to be a dog or a cat and get really overinvolved. Young children have quite different reality-testing to adults. Adults don't adopt personas per se but do act differently and pervasively depending on the role they are in, hence a doctor, lawyer, rock musician will have a different selection of behaviours if they are in their job role, with friends, or family etc. Anyway this is getting off topic but I'll try and take a look at the research. Casliber (talk · contribs) 13:07, 2 August 2012 (UTC)

• 2 Reverts by WLU last night

PROVEIT - 1. The point here is that what WLU has on the DID page, using the Boysen reference is not what Boysen said. WLU at this point would say PROVEIT. I think he needs to type the section of the article here that says what he claims or the section be deleted.~ty (talk) 16:48, 2 August 2012 (UTC)

Personality - 2. We have agreed on this talk page that using the term personality is confusing to those who are not well versed in psychology. I do agree that "personality" is the original term used here and thus it should stay, however at the same time in writing we normally put in something like (personality states) to make it clear when the original term could be confused. Can we do this here?~ty (talk) 16:52, 2 August 2012 (UTC)

WP:PROVEIT applies to the removal of unsourced information. Feel free to request the article for the author or WP:LIB but if you haven't read it beyond the abstract, you shouldn't assume your interpretation is correct. Where did we agree that the term "personality" is confusing? I don't recall agreeing to that, and I just disagreed below. I think this is an inappropriate application of original research that is unsupported by the body of literature. If specific sources use personality states, in particular if they discuss why they use these terms, great - make that portion of the text reflect this. But if a source feels the need to defend the use of a specific term - that suggests the term is idiosyncratic rather than universal and thus should not be used in general. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:18, 3 August 2012 (UTC)

Well referenced text continues to be removed

In this edit the key point that "Prognosis when untreated, is poorly understood" was removed with the inaccurate summary of "add back another part" [8]. This has now occurred a number of times and I have replaced it again. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 17:38, 2 August 2012 (UTC)

My error. I offer apologies!!!~ty (talk) 17:46, 2 August 2012 (UTC)

Okay no worries. Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:20, 3 August 2012 (UTC)

:) ~ty (talk) 17:26, 3 August 2012 (UTC)

Question about references

If a reference mentions a certain point, but the point of the reference is to disagree with what that point, should it be used as a reference to support the subject it is arguing against? One example below?

Therapist induced - header

• It has been suggested that symptoms of DID may be created by therapists using techniques to "recover" memories with people who are suggestible (such as the use of hypnosis to "access" alters, facilitate age regression or retrieve memories).
• [34][11][13][12][23]

• [34] - Piper and Merskey are good here. That is what they argue is the iatrogenic position.
• [11] - Blackwell - Can WLU show the text that says this. This book is referenced a lot in this article. Is there a link in google books or something? If not can WLU please supply the text where it says this.
• [13] - Book - Cardena and Gleaves - these 2 support traumalology. pages 473 to 503. Can that be narrowed down the page that actually says this please. Page 473 says "Detractors find some of them (being DD in general) particularity DID, suspect, if not outright iatrogenic; ... then they go on to explain why the POV of the detractors is incorrect. This is not a quote supporting the theory of iatrogensis at all.
• [12] - This is the same Piper and Mersky article as [34]
• [23] - This one is the Boysen review that we were looking at pertaining to children. I have no idea why this reference would be here in support of this statement. ~ty (talk) 02:26, 3 August 2012 (UTC)

Cardena et al. are saying why they disagree with a position, why they think it is incorrect. It is not settled yet whether they are right in their beliefs (either side).

Sources can be used to verify positions they disagree with, an appropriate use of a source also indicates this disagreement and discusses why.

Piper & Merskey wrote two articles, part I and part II, 12 and 34 are not the same. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:08, 3 August 2012 (UTC)

Question for Mathew, Doc and Casliber - Since I have learned on WP that few editors agree on fine points like this, can I also hear from Mathew, Doc and Casliber? I would think that if this is allowed it would cause confusion in any articles. If I look at a citation I want to see support for the position that it is cited for. Piper and Mersky are wonderful for this section and should be included here.~ty (talk) 02:26, 3 August 2012 (UTC)

to Tylas

Please don't cut and paste citations as you did above. Put clickable sources in your statement. The cut-and-paste numbers will change if someone adds another citation. And it makes it hard to figure out what you're saying since I have to go back and forth from your cut-and-paste to the article. MathewTownsend (talk) 15:38, 4 August 2012 (UTC)

Okey dokey - you were suppose to look that day, not wait until now. ;) Just kidding. I am happy to do so and it makes total sense! :) ~ty (talk) 15:40, 4 August 2012 (UTC)

Sources to replace or support information in the article

Interesting points Mathew. WLU, I was not looking to replace the iatrogenic stuff, I was just wondering if that was a good source to use, but since you bring it up, there are lots of references out there that could be used to show that iatrogenic and trauma/DA are not equal. Doing a quick search of reviews, here is the first one I found:

*Abstract "The incidence of dissociative identity disorder (DID) is strongly correlated with exposure to serious physical and sexual abuse. Although studies of more than 1,000 DID sufferers indicate that severe child abuse is a predisposing factor in 95% to 98% of cases (B. Braun, 1988), abuse alone is not, in fact, predictive of DID (B. Rind & P. Tromovitch, 1997). Disorganized/disoriented attachment style and the absence of social and familial support, in combination with abuse history, best predict DID (D. Howe, 2006; R. Kluft, 1984; K. Lyons-Ruth, L. Dutra, M. Schuder, & I. Bianchi, 2006)."

I am going to add this information to the trauma section, when I have a moment. Any objections before I do? It is a review article and it is newer.~ty (talk) 04:58, 5 August 2012 (UTC)

Consolidated references

As far as I can tell I've consolidated all the references so there is no more duplication of sources. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:40, 5 August 2012 (UTC)

Is Medscape - (updated May 2012) a good ref?

If it is, it counters some of the claims in the WP article. Here are a couple of examples:

• the most common cause of the disorder is agreed to be early, ongoing, extreme physical and/or sexual abuse
• Dissociation is the disruption of the normal integrative processes of consciousness, perception, memory, and identity
• is increasingly understood as a complex and chronic posttraumatic psychopathology closely related to severe, particularly early, child abuse (ref used for this: Shipman K, Taussig H. Mental health treatment of child abuse and neglect: the promise of evidence-based practice. Pediatr Clin North Am. Apr 2009;56(2):417-28. [Medline].)
• The existence of significant dissociative psychopathology related to physical and sexual abuse experienced in childhood was known to clinicians in the last century. However, only recently have modern mental health practitioners begun to appreciate implications of this forgotten linkage.~ty (talk) 15:43, 5 August 2012 (UTC)

It's a useful source for basic information, much like a textbook, but it's not enough to over-write the more specific secondary sources that address specific points. For instance, you couldn't use it as a justification to eliminate all the iatrogenesis material, nor could you use its general info to contradict secondary sources. Looks like it would be useful for expanding mostly the traumagenesis position, but you're still better off using specific secondary sources whenever available. You could always take the question to the reliable sources noticeboard. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:57, 5 August 2012 (UTC)

(edit conflict)

I'd say no.

Look at the references they list for the Medline article. Only a few deal with DID. Most refer generally to "dissociation" if they mention it at all. Many are on child abuse without mentioning dissociation. Many are on PTSD. Most are primary research. Many were done in the 1980s and 1990s. The article seems to confuse DID, dissociation, PTSD. There is a huge concentration on studies of child abuse but they don't have solid review articles linking it to DID. Many other problems with the references.

Look for yourself:

References

• Shipman K, Taussig H. Mental health treatment of child abuse and neglect: the promise of evidence-based practice. Pediatr Clin North Am. Apr 2009;56(2):417-28. [Medline].

• Cicchetti D, Lynch M. Toward an ecological/transactional model of community violence and child maltreatment: consequences for children's development]. Psychiatry. Feb 1993;56(1):96-118. [Medline].

• Cicchetti D, Rogosch FA. Psychopathology as risk for adolescent substance use disorders: a developmental psychopathology perspective]. J Clin Child Psychol. Sep 1999;28(3):355-65. [Medline].

• Kluft RP. Diagnosing multiple personality disorder. Pa Med. Sep 1984;87(9):44, 46. [Medline].

• Kluft RP. An update on multiple personality disorder. Hosp Community Psychiatry. Apr 1987;38(4):363-73. [Medline].

• Carmen EH, Rieker PP, Mills T. Victims of violence and psychiatric illness. Am J Psychiatry. Mar 1984;141(3):378-83. [Medline].

• Richter JA, Serena A, Charvet MA, Virto R, Errasti P. Ureteral fistula after renal transplantation: the significance of delayed images. Eur J Nucl Med. 1984;9(9):436-7. [Medline].

• Lauterbach D, Somer E, Dell P, Vondeylen H. Abuse history and pathological dissociation among Israeli and American college students: a comparative study. J Trauma Dissociation. 2008;9(1):51-62. [Medline].

• Edwards VJ, Holden GW, Felitti VJ, Anda RF. Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: results from the adverse childhood experiences study. Am J Psychiatry. Aug 2003;160(8):1453-60. [Medline].

• Wherry JN, Neil DA, Taylor TN. Pathological dissociation as measured by the child dissociative checklist. J Child Sex Abus. Jan-Feb 2009;18(1):93-102. [Medline].

• Anderson SC, Bach CM, Griffith S. Psychosocial sequelae in intrafamilial victims of sexual assault and abuse. Amsterdam, Netherlands: April1981. Third international conference on child abuse and neglect.

• Tuft's New England Medical Center, Division of Child Psychiatry. Sexually exploited children: Service and research project. Final report for the office of Juvenile Justice and Delinquency Prevention. Washington, DC: US Department of Justice; 1984.

• Putnam FW, Guroff JJ, Silberman EK, Barban L, Post RM. The clinical phenomenology of multiple personality disorder: review of 100 recent cases. J Clin Psychiatry. Jun 1986;47(6):285-93. [Medline].

• Middleton W, Butler J. Dissociative identity disorder: an Australian series. Aust N Z J Psychiatry. Dec 1998;32(6):794-804. [Medline].

• Macfie J, Cicchetti D, Toth SL. The development of dissociation in maltreated preschool-aged children. Dev Psychopathol. Spring 2001;13(2):233-54. [Medline].

• Howe ML, Toth SL, Cicchetti D. Can maltreated children inhibit true and false memories for emotional information?]. Child Dev. May-Jun 2011;82(3):967-81. [Medline].

• Toth SL, Pickreign Stronach E, Rogosch FA, Caplan R, Cicchetti D. Illogical thinking and thought disorder in maltreated children. J Am Acad Child Adolesc Psychiatry. Jul 2011;50(7):659-68. [Medline].

• Gast U, Rodewald F, Nickel V, Emrich HM. Prevalence of dissociative disorders among psychiatric inpatients in a German university clinic. J Nerv Ment Dis. Apr 2001;189(4):249-57. [Medline].

• Sar V, Akyuz G, Kundakci T, Kiziltan E, Dogan O. Childhood trauma, dissociation, and psychiatric comorbidity in patients with conversion disorder. Am J Psychiatry. Dec 2004;161(12):2271-6. [Medline].

• Hulette AC, Freyd JJ, Fisher PA. in middle childhood among foster children with early maltreatment experiences. Child Abuse Negl. Feb 2011;35(2):123-6. [Medline]. [Full Text].

• Gutierrez Wang L, Cosden M, Bernal G. Dissociation as a mediator of posttraumatic symptoms in a Puerto Rican university sample. J Trauma Dissociation. 2011;12(4):358-74. [Medline].

• Evren C, Sar V, Dalbudak E, Cetin R, Durkaya M, Evren B. Lifetime PTSD and quality of life among alcohol-dependent men: impact of childhood emotional abuse and dissociation. Psychiatry Res. Mar 30 2011;186(1):85-90. [Medline].

• Tezcan E, Atmaca M, Kuloglu M, Gecici O, Buyukbayram A, Tutkun H. Dissociative disorders in Turkish inpatients with conversion disorder. Compr Psychiatry. Jul-Aug 2003;44(4):324-30. [Medline].

• Foote B, Park J. Dissociative identity disorder and schizophrenia: differential diagnosis and theoretical issues. Curr Psychiatry Rep. Jun 2008;10(3):217-22. [Medline].

• Allison RB. Multiple personality and criminal behavior. Am J Forensic Psychiatry. 1981;2:32-38.

• Weber S. Treatment of trauma- and abuse-related dissociative symptom disorders in children and adolescents. J Child Adolesc Psychiatr Nurs. Feb 2009;22(1):2-6. [Medline].

• Bierer LM, Yehuda R, Schmeidler J, et al. Abuse and neglect in childhood: relationship to personality disorder diagnoses. CNS Spectr. Oct 2003;8(10):737-54. [Medline].

• Brown GR, Anderson B. morbidity in adult inpatients with childhood histories of sexual and physical abuse. Am J Psychiatry. Jan 1991;148(1):55-61. [Medline].

• Brown RJ. Different types of "dissociation" have different psychological mechanisms. J Trauma Dissociation. 2006;7(4):7-28. [Medline].

• Chu JA, Frey LM, Ganzel BL, Matthews JA. Memories of childhood abuse: dissociation, amnesia, and corroboration. Am J Psychiatry. May 1999;156(5):749-55. [Medline].

• DeFrancis V. Protecting the Child Victim of Sex Crimes Committed by Adults. Denver, CO: Children's Division, American Humane Association; 1969.

• Dorahy MJ, Lewis CA. Dissociative identity disorder in Northern Ireland: a survey of attitudes and experience among clinical psychologists and psychiatrists. J Nerv Ment Dis. Oct 2002;190(10):707-10. [Medline].

• Ellason JW, Ross CA. Two-year follow-up of inpatients with dissociative identity disorder. Am J Psychiatry. Jun 1997;154(6):832-9. [Medline].

• Foote B, Smolin Y, Kaplan M, Legatt ME, Lipschitz D. Prevalence of dissociative disorders in psychiatric outpatients. Am J Psychiatry. Apr 2006;163(4):623-9. [Medline].

• Lewis DO, Yeager CA, Swica Y, Pincus JH, Lewis M. Objective documentation of child abuse and dissociation in 12 murderers with dissociative identity disorder. Am J Psychiatry. Dec 1997;154(12):1703-10. [Medline].

• Putnam FW. Diagnosis and Treatment of Multiple Personality Disorder. New York, NY: Guilford Press; 1989.

• Putnam FW. Ten-year research update review: child sexual abuse. J Am Acad Child Adolesc Psychiatry. Mar 2003;42(3):269-78. [Medline].

• Sar V, Koyuncu A, Ozturk E, et al. Dissociative disorders in the psychiatric emergency ward. Gen Hosp Psychiatry. Jan-Feb 2007;29(1):45-50. [Medline].

• Simeon D, Guralnik O, Schmeidler J, Sirof B, Knutelska M. The role of childhood interpersonal trauma in depersonalization disorder. Am J Psychiatry. Jul 2001;158(7):1027-33. [Medline].

• Vogel M, Spitzer C, Kuwert P, Moller B, Freyberger HJ, Grabe HJ. Association of childhood neglect with adult dissociation in schizophrenic inpatients. Psychopathology. 2009;42(2):124-30. [Medline].

• Wilbur CB. Multiple personality and child abuse. An overview]. Psychiatr Clin North Am. Mar 1984;7(1):3-7. [Medline].

• Xiao Z, Yan H, Wang Z, et al. Trauma and dissociation in China. Am J Psychiatry. Aug 2006;163(8):1388-91. [Medline].

MathewTownsend (talk) 02:03, 5 August 2012 (UTC)

'Let me ask another question to all'. Is the Medscape sight normally considered to be a good reference for WP especially when it's been updated in 2011? It is getting to feel like what is normally accepted on WP is not here on the DID page for whatever reasons. If so, can someone explain please.~ty (talk) 15:36, 5 August 2012 (UTC)

Reply to Mathew - I am not seeing a problem with the references used by Medscape at all - Heck Kluft is considered THE number one expert in DID, trauma studies and child abuse studies are very much about DID if that is what they are looking at, F. Putman! Have you read his book!, Chu - same thing... read the book!, Sar is used often on this page.. I just don't see any problem at all with their citations.~ty (talk) 15:43, 5 August 2012 (UTC)

Reply to WLU - Thank you for this link WLU - reliable sources noticeboard I will look into this. Do you have secondary sources that can refute what Medscape says? Please present them or I will consider it that you do not. (as you keep doing) ~ty (talk) 15:43, 5 August 2012 (UTC)

reply to Tylas

So it doesn't bother you that most of the articles cited by Medscape for their article on DID were published in the 1980s and 1990s, don't mention DID, and are mostly about abuse of children? Except Kluft's 1987 article where he says "it is most parsimoniously understood as a chronic dissociative posttraumatic stress disorder, and that it has an excellent prognosis when intensive and prolonged psychotherapy with an experienced clinician is available."?

Have you read reliable sources for medical aritcles? MathewTownsend (talk) 17:10, 5 August 2012 (UTC)

Reply to Mathew - Not in the real world, this is how an article is wrote, and medscape is a respected sight. I will let this reference go for now - since I do respect your knowledge of WP.~ty (talk) 14:33, 6 August 2012 (UTC)

Note to Mathew - I have been adopted! I am willing to put in the time to make this article correct. Be patient with me please! I just started school today! ;) ~ty (talk) 15:14, 6 August 2012 (UTC)

Question for Mathew - I was looking at this site again, doing another project off WP and I was looking at the authors. Many work with children. Perhaps this is the reason for there being many articles linked to pediatrics. Could this not also be seen as those experts who understand children including DID? With this understanding does that not give more credit to the citations list - those are Experts on children looking at DID and how it affects children.

Article authors: Contributor Information and Disclosures Author

Muhammad Waseem, MD Associate Professor of Emergency Medicine in Clinical Pediatrics, Weill Medical College of Cornell University; Consulting Staff, Department of Pediatrics, Bronx Lebanon Hospital; Consulting Staff, Department of Emergency Medicine, Lincoln Medical and Mental Health Center

Muhammad Waseem, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Heart Association, and American Medical Association

Disclosure: Nothing to disclose. Coauthor(s)

Muhammad Aslam, MD Instructor in Pediatrics, Harvard Medical School; Staff Physician, Department of Medicine, Division of Newborn Medicine, Children's Hospital Boston

Muhammad Aslam, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Medical Association, Massachusetts Medical Society, and Southern Medical Association

Disclosure: Nothing to disclose.

Richard M Switzer, Jr, MD Consulting Staff, Department of Pediatrics, Brooklyn Hospital Center

Richard M Switzer, Jr, MD is a member of the following medical societies: American Academy of Pediatrics and American Medical Association

Disclosure: Nothing to disclose.

Orlando Perales, MD Associate Director of Pediatric Emergency Services, Department of Emergency Medicine, Lincoln Medical and Mental Health Center

Orlando Perales, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose. Specialty Editor Board

Carol Diane Berkowitz, MD Executive Vice Chair, Department of Pediatrics, Professor, Harbor-University of California at Los Angeles Medical Center

Carol Diane Berkowitz, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, American College of Emergency Physicians, American Medical Association, American Pediatric Society, and North American Society for Pediatric and Adolescent Gynecology

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Caroly Pataki, MD Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Carrie Sylvester, MD, MPH Senior Child and Adolescent Psychiatrist, Sound Mental Health

Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry

Disclosure: Nothing to disclose. Chief Editor

Caroly Pataki, MD Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

~ty (talk) 19:45, 6 August 2012 (UTC)

reply to Tylas

No. Because the articles are out of date, and almost none of those articles indicate that the author is familiar with DID. (Remember "dissociation" or "dissociative disorders" are not the same as DID.) Besides, lots of disorders have a high past history reported of child abuse. (Schizophrenia and Borderline personality, for example. And the field has changed a lot since the 1980s and 1990s) Please read WP:MEDRS. MathewTownsend (talk) 20:09, 6 August 2012 (UTC)

Reply to Mathew - But (I have to have a but in here - because I just have to make sure before I give up!) I will go and read that page <right now even while its on my mind>, but in the meantime - my point, that I did not make clear, is that those that wrote the article - are they not considered experts in what they wrote about references aside. In a research article the references are rarely new.~ty (talk) 20:21, 6 August 2012 (UTC)

This is getting into a lot of personal assessments and WP:OR. It might be better to simply kick this to the WP:RSN. WLU (t) (c) Wikipedia's rules:^simple/_complex 21:39, 6 August 2012 (UTC)

Reply to WLU - Thank you Sir, but I prefer to learn from Mathew for a bit first. I am not set on this at all. I am just pointing things out that I wonder about. We can gave that avenue for things that we are actually divided about, but thank you for the input. I appreciate it.~ty (talk) 21:46, 6 August 2012 (UTC)

Prognosis trim

I removed the following text from the prognosis section:

Changes in identity, loss of memory, and loss of time often lead to chaotic personal lives, since it is common for highly dissociated "personality states" to not know what other "personality states" know due to the amnestic barrier between those "personality states". Psychotherapy for adults usually takes years depending on the patients goal. Unifying or "integrating" the various "dissociated states" of the "personality" is considered best for the patient allowing them to finally operate as a unified "personality" and to have freedom of the crippling effects of DID. Some patients however, for personal reasons, cannot bring themselves to do this, instead they opt to obtain an acceptable level of coconscious, still retaining their dissociated "personality states", but with reduced amnesic barriers.

Prognosis is about the clinical course of a patient. Most of these are symptoms, which is why I moved them to the symptoms section. What isn't a symptom is mostly material for the treatment section, though I've retained the bit about duration and goals of treatment.

Also, Tylas, you do not understand how a ref name tag works. The whole point of a ref name tag is to have a single citation that can be used multiple times. That means there is only one ref name tag with a citation attached, not a series of ref name tags each with a quote attached. If you really feel the need to append a quote next to a citation, I suggest using invisible text, but as I've said before - the quotes are only useful if someone is contesting the material and you're better off just discussing that particular summary and quote than appending it to the text (particularly in a form that doesn't actually display in the footnotes). WLU (t) (c) Wikipedia's rules:^simple/_complex 01:52, 5 August 2012 (UTC)

I did it that way and you delete it. I do it as Doc James suggested and you delete it. There is nothing that I have ever wrote that you have allowed to remain on this page. Not one thing! Still the only thing there is one picture, and the text under the picture that Doc James added. Since you say all this text is treatment, and I know it is well sourced, I will put the text under treatment.~ty (talk) 02:49, 5 August 2012 (UTC)

What's wrong with my changes? WLU (t) (c) Wikipedia's rules:^simple/_complex 22:37, 5 August 2012 (UTC)

You answer my questions first, since they were proposed first please.~ty (talk) 14:54, 6 August 2012 (UTC)

You didn't pose a question here. I have no objection to treatment information being put in the treatment section. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:48, 6 August 2012 (UTC)

Reply to WLU - Do you do understand that I ask this because I have not yet been allowed to contribute anything to this article (other than images) that you have not deleted or reverted. Thank you for your reply. I will work on integrating the information you deleted from the prognosis section into where you feel it fits better - under treatment.~ty (talk) 17:02, 6 August 2012 (UTC)

Personality confusion

I can't find the section even in the archives, but this is the idea of why using the term personality is confusing to most. Again, I agree with Matthew that personality states is a good idea.

F. Putnuam reported back in 1977 that no "personality state" is an "original part." There is no original part. A persons sense of self is "built up and synthesized over time. E. Howell (2011) adds to this that "the usually presenting part is, by definition, a part in relation to and in relationship with other parts in the total organization of the personality. Current research in neurobiology, cognitive psychology, and developmental psychology indicates that the brain, the mind, and the self are normally multiple. The brain is organized into "neural system" - these systems "function independently. So, no one is born with one unified self (personality). During infancy, behavior is organized as a set of discrete behavioral states (such as deep sleep, awakening, eating) which link and group together in sequences over time. For the natural process of integration to proceed correctly, a child must attach to at least one of their primary caregivers. All people have multiple states or parts of the personality - these parts are called ego states. In the healthy mind, a person can switch from ego state to ego state, which is a smooth process that goes without much notice. Once you understand how the normal process works, then understanding DID is much easier. With the information above in mind, now consider how forming a unitary self can deviate from the norm and cause a major dissociative disorder such as DID. Natural integration which normally occurs during childhood does not take place for whatever reasons. The cohesive self (with it's many ego states) is not formed. Instead of ego states dissociated states (parts) or alters are created.

So, to avoid confusion by readers, I request that we use the term "personality states" rather than "personality."~ty (talk) 22:06, 2 August 2012 (UTC)

No. Not all authorities agree with this position, not all sources use this terminology, and it would involve rewriting the page according to a small number of one-sided authors' opinions that you happen to agree with. The definitions are not agreed upon, there are several sources pointing out that they are vague and undefined. This confuses the issue further and would make sources say things they fundamentally do not say, it does not clarify it.

Again, your position is not the correct position, and sources you agree with are not the most authoritative ones. Unless there is unambiguous agreement on a point from most to all sources, we should not portray it as a settled issue. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:01, 3 August 2012 (UTC)

Reply to WLU - This is basic psychology. How can they not agree with this? It is accepted in almost all psychology that the personality is made up of states. I agree there is controversy about why those states can become dissociated as in DID, but it is well known that the personality is made up of various parts. Even if one or two out there think different, almost everyone accepts this. Heck, I can find someone that will disagree with just about anything. This is not my opinion. It is psychology. Having one personality is how it was thought things were back in history - but not today.~ty (talk) 02:10, 3 August 2012 (UTC)

Did you read the information I linked to? I do not pick and choose sources to agree with, but Paul F. Dell is a leader in the world of psychology and I did point to his book, but only because it came up in the search engine. Using the label that is used in the DSM (as Mathew pointed out) will clarity things. Throwing around the word personality is totally confusing.~ty (talk) 02:10, 3 August 2012 (UTC)

Because it's not basic psychology, it's a point of disagreement within the DID literature, and the articles and books don't use the term "parts of the personality". By making a book that says "personality" say "parts of the personality" it is a subtle misrepresentation but it is still a misrepresentation. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:13, 3 August 2012 (UTC)

I have never read that this is a point of controversy. Could you show me sources please. Thank you for your reply.~ty (talk) 02:18, 3 August 2012 (UTC)

To WLU - As you have provided many an example that either someone answers you with a satisfactory answer or you do as you want in the article, I demand an answer here or will assume you cannot find one and in that case for this article we need to assume that this controversy you want to push so much is not equal to the mainstream consensus of trauma and DA. You have avoided the direct question so far, yet have continued to delete every single edit I have made. Please answer with direct references to support your POV.~ty (talk) 15:33, 5 August 2012 (UTC)

As I say below, Harper notes that there is a lack of definition for dissociation. Kihlstrom, 2005 also notes that most of the terms are undefined. Not to mention there is no standard terminology, some sources use "alter", some use "identity", some use "personality state". The DSM itself uses both, and it's probably the most authoritative, generally-accepted source that exists in mental health.

You are correct, the ability to support a POV is through sources. I have provided ample sources indicating DID is controversial, and Reinders, 2008 notes it as "one of the most controversial diagnoses". Gillig, 2009 includes the word "controversial" in the title. In fact, nearly every source notes that it is controversial. I believe that is sufficient. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:15, 6 August 2012 (UTC)

Personality states

DSM-IV uses this as criteria A in its Diagnostic criteria for DID:

"The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self)." I think this is as close as we can come to a definition of "personality states".

MathewTownsend (talk) 17:43, 3 August 2012 (UTC)

I agree!~ty (talk) 17:51, 3 August 2012 (UTC)

I think this underscores my comment about there being a lack of consensus on terminology, and therefore the page should not insist on a single term on the entire page. If a source uses "personality", stick with that. If it uses "personality states", ditto. If it discusses the meaning and difference between the two, that's an excellent article to include to elaborate on the fact that the two lack or have problematic definitions. This edit replaces "personality" with "personality states" throughout the section - but Merck uses those terms so it is fine in my opinion. The scare quotes are probably unnecessary though. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:15, 4 August 2012 (UTC)

I disagree. WP is an encyclopedia. The goal is to decrease confusion, not add to it. One cannot have multiple personalities, everyone has multiple parts to their ONE personality. Most of you know these parts, the part that goes to work, the part of you that wants to lay in bed all day, the part that wants to be alone, the part that wants company, the part that wants.... well you get the idea. To not identity "personality states" from "personality" on a site read by lay people is confusing. The confusion is the interpretation by lay people, not in the labels themselves.~ty (talk) 02:27, 4 August 2012 (UTC)

Portraying the DID literature as if it were consistent on this point is not confusing, but it is incorrect, and that's worse. Simple but wrong is still wrong. We are not simple English wiki and even if we were, it would still be wrong. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:29, 4 August 2012 (UTC)

Just because someone does not understand something does not make it incorrect or inconsistent. As Mathew has suggested, the DSM IV terms are ideal to use. ~ty (talk) 02:36, 4 August 2012 (UTC)

The DSM-IV uses both terms. Again, this indicates a lack of a single, agreed-upon term. WLU (t) (c) Wikipedia's rules:^simple/_complex 03:08, 4 August 2012 (UTC)

Again, the DSM is not written for the lay person, the health care professional knows the difference. To eliminate confusion on this page, it's best to stick with what does not confuse. Do you want people confused? What am I missing? Why do you fight this point so much? Please explain. I am confused.~ty (talk) 03:15, 4 August 2012 (UTC)

Because I think it inappropriately misrepresents the debate, because I think it favours one narrow interpretation of the sources over another, because I think it is another example of you applying your personal opinion over what the sources actually says, and because I think "personality" and "identity" are far clearer terms than "personality-states". WLU (t) (c) Wikipedia's rules:^simple/_complex 03:41, 4 August 2012 (UTC)

Everything is not about debate - as Mathew said it makes it look like a battle zone (or something to that effect). The idea of an encyclopedia is to inform, rather than to confuse with excess controversy - that in this case is minute in the whole of things. When someone comes to this page they should read the mainstream consensus on DID which is trauma and DA based. Then of course any controversy should be presented, but to build the site to keep confusion going seems so wrong and I can't understand why you fight for this. Please quit saying it is my personal opinion - it is the consensus of mainstream psychology. Please see Merek, which sums it up nicely. I have no problem presenting iatrogensis, as I have said over and over again, but what I try and present is the mainstream thought of psychology, not of the lay people who watch movies and think that is what DID is - it is not! There are already sites on WP for that sort of thing.~ty (talk) 04:01, 4 August 2012 (UTC)

I agree, we should inform people that there's debate over the terminology, including personality versus personality state.

Also, the mainstream consensus is not "DID is trauma based". That is the consensus at the J Trauma Dissociation, but it's not universal. Merck is one source, an overview source, but it is not the only source. There is genuine, significant debate about DID in the literature, and the page should reflect this. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:46, 4 August 2012 (UTC)

This is your opinion. I asked for current references that say this please. Show me this genuine, significant information that says that the iatrogenic position is a mainstream consensus of DID. I don't think this is possible, because it is not, but, as you demand, I feel your next work on this page should be to supply such references, please. Thank you for your time.~ty (talk) 14:46, 6 August 2012 (UTC)

Reply to WLU - The debate is not over terminology; what is meant for the professional can easily be misunderstood by the lay person - as with what a personality is. Find me something that says that the mainstream consensus is NOT trauma and DA based - or that even half of it is not. I don't think you will be able to find anything that is recent, because that's just not how it is. There is a minority view, in the literature, that mainstream science is trying to put to rest. Also, I doubt anyone disagrees that poor therapy can create a temporary alter - that is not a debate. What is a problem is that these people say that this type of therapy can actually create DID! DID is not about having a temporary "dissociated state" or two, and that's okay for a group to argue this, but that does not make this view equal to mainstream psychology. And Merck is a dang good source and sums up what most good sources also say.~ty (talk) 14:06, 4 August 2012 (UTC)

Harper, 2011, "Van der Hart et al. (2008) reviewed 53 empirical studies on the relationship between peritraumatic dissociation and post-traumatic stress and were surprised to find that not one study attempted to offer a definition of dissociation...Last, Kennerley (2009) concludes that so far, there is no model for dissociation that is well defined; in other words dissociation as a concept remains ill-defined." There is no mainstream consensus, that's kinda the point. If there were a mainstream consensus, we wouldn't be having that discussion, we'd be discussing the consensus and wrinkles and criticisms thereof. You can argue what you personally believe, but that doesn't make the arguments in the literature disappear. Mainstream science does not "put to rest" a concept, it tests against predictions to see if a hypothesis is supported or not. Above all, science does not assume an answer is correct and ignore alternatives. To date, neither model has absolute support and it is blatantly inappropriate to make the page say "the traumagenic model is right and the iatrogenic model is wrong". You think Merck is a good source because it agrees with your opinion, that is an excellent way to write a biased page and a terrible way to write a nuanced one. WLU (t) (c) Wikipedia's rules:^simple/_complex 14:46, 4 August 2012 (UTC)

Do you understand what van der Hart et al. are saying? It does not seem so. This is not an answer to the question above, it is a copy and pasted statement that is out of context. I have read the Haunted Self and the studies on structural dissociation. You again, Sir appear to again be taking things out of context and manipulating them to say what they do not mean - but instead what you want to argue. The point of van der Hart et al. is to narrow down, as I have argued in another post on this talk page yesterday is that pathological dissociation differs from every day dissociation. This distinction is important to understand if you are to understand structural dissociation and ANP's, EP's, etc... ~ty (talk) 15:01, 4 August 2012 (UTC)

Reply to WLU - You have worked on the page, but ignored this inquiry. I will take that as you submit and we can use the term pathological dissociation to distinguish it from every day dissociation.~ty (talk) 14:37, 6 August 2012 (UTC)

Please stop putting words in my mouth, if I do not say something explicitly that does not mean I am agreeing to whatever you think or want my silence to mean. In this case silence does not indicate consensus, it usually means I am tired of being accused of bad faith. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:41, 7 August 2012 (UTC)

Reply to WLU - I am only doing as you do on this page. You demand an immediate answer and say if you do not get one then you assume you are correct and that I am wrong - which you do even if I do answer. I will stop if YOU stop! Don't do things and then get mad when I learn those ways from you and do them back. Again - I do not have any edits on the entire DID page except one image and the caption under another. I do not think you are the one being picked on here. You have wrote almost the entire page yourself. ~ty (talk) 21:37, 7 August 2012 (UTC)

The iatrogenic position is not the mainstream consensus for DID

The Iatrogenic position is not a significant controversy to warrant more than one controversy section on the WP DID page - which I do strongly feel should be presented. I am bringing this important question to the forefront of discussion, since it is the point of controversy on this page (but not in the real world) and the question keeps getting shoved aside. I asked WLU a direct question which he has not yet answered - other than to give his own POV. I will ask it again below.

I have asked WLU for current references that say that the iatrogenic position is a mainstream consensus of DID, but I only get his personal opinion on it. As WLU often does, I must demand his next work on this page should be to supply such references.

On the otherhand, it is cited over and over again, in text books, on medical sites and in research that THE mainstream consensus is that childhood trauma (and DA) is the cause of DID.~ty (talk) 14:53, 6 August 2012 (UTC)

I don't think the page depicts iatrogenesis as the mainstream position on DID. Per WP:STRUCTURE, a controversy section is a bad idea as the controversies and debates should be interstitched throughout the page. The current structure, which ghettoizes a large chunk of criticisms to a single section, is sub-optimal. You seem to be blaming me for integrating reliable sources which point out and discuss the controversies about DID. That is how a page is written, that is part of the NPOV policy. The fact that so many sources mention and discuss the controversies about DID indicates that it is indeed a controversial diagnosis. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:04, 6 August 2012 (UTC)

Reply to WLU - So we agree on the point that the iatrogenic view is not mainstream.~ty (talk) 16:17, 6 August 2012 (UTC)

Reply to WLU - The next point. I looked at the link you gave and see this: Neutrality requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint. The bolded section is of great importance here - in proportion to the prominence of each viewpoint.~ty (talk) 16:17, 6 August 2012 (UTC)

I didn't say that the iatrogenic view is the mainstream one, I said I didn't think the current page depicts the iatrogenic position as the mainstream one. I don't know which is mainstream. I do know both should be discussed.

Yes, that is the position of NPOV, and the proportion and prominence is determined by number of sources discussing it, and to a certain extent the impact of the sources. In my experience, generally this is done by saturating the page with sources - keep adding reliable sources as appropriate until you can't add anymore. The subsequent page is normally neutral, as long as the sources are reliable. The overall point is - editors do not determine which is the mainstream view, sources do. For instance, 2011 Mellsop states on page 334 "[DID] has respected advocates for its posttraumatic ubiquity (Briere, 1996) and equally respected opponents of the view that it is largely a therapist induced artefact (Piper & Merskey, 2004)." This could be use to indicate that DID is indeed controversial, the dispute is over traumagenesis and iatrogenesis, and this position is still being debated in 2011. Most importantly, it is a source that is saying this, not an editor. WLU (t) (c) Wikipedia's rules:^simple/_complex 16:47, 6 August 2012 (UTC)

Reply to WLU - You are again trying to confuse the point. I do not see what you have done on the DID page as what is described in the first part of your reply above. I see you ignore the mainstream consensus on DID and attempt to saturate the page with the minority iatrogenic POV - making yourself sole judge of what is allowed on the page. This has been the problem on the DID page that editors cannot get past. Again, I must point out that I have not been allowed to keep one edit on the entire DID page other than an image and the text beneath another image. This is not the process you just described. The source and information saturation is one sided directed at your POV -- the iatrogenic position.~ty (talk) 16:56, 6 August 2012 (UTC)

The causes of all psychiatric disorders is unknown. We still typically discussed the proposed theories in a section on causes even though they are all tentative (ie without consensus). Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:49, 6 August 2012 (UTC)

All? There is still a mainstream concensus by the experts in the field. You are a Doc. Do you really buy that watching a TV show or reading a book could cause DID?~ty (talk) 21:21, 7 August 2012 (UTC)

To Tylas

Please listen to Doc James! The causes of all psychiatric disorders is unknown. All proposed "theories" are tentative. The "schizophrenogenic mother" used to be blamed for schizophrenia; now we think it's primarily an inherited predisposition. What someone (even an expert) thought in 1984 about child abuse and "multiple personality" is not necessarily what we think today. Knowledge is not "fixed". That's why we must concentrate on recent research and recent thinking. Consider that we can't define "dissociation" today, or even "personality"! The field is rapidly changing -- very rapidly.

When so many children get abused, why do only some become DID? There are too many unanswered questions to push a particular "cause" of DID. Please lets explore the possibilities as set forth in the literature, and not push one point of view or another. I think more research on the workings of "memory" and examination of "normal dissociation" which we all engage in every day is needed. After all, the concept "personality" is only a model. Maybe we all are "multiple personalities" in one way or another. We all recognize that "memory" can often be false. (Mine certainly can be.) — Preceding unsigned comment added by MathewTownsend (talk • contribs) 19:15, 7 August 2012 (UTC)

Everyone please Read the section below: Note in my explanation that the cause is not always abuse, but it is always trauma in REAL DID (not therapeutic creation of temporary dissociated personality states) - and before the personality can gain normal integration - which is early in life.

Reply to Mathew: Also please note that I do agree that the 1980's psychology was a mess! It is 2012 now though. Also we can define dissociation! Saying that DID is caused from watching TV and reading a book is nuts. The false memory battle has nothing to do with DID and should not even be dragged into the conversation. Yes, we all have multiple parts to our one personality. DID has little to do with repressed memories of child sexual abuse - in DID dissociated states hold the memories, but trying to remember the abuse is not a goal of therapy in DID! Breaking down the dissociative barriers is! What you wrote is not what DID is about! Those with DID have horrendous symptoms that they need to deal with and it has been shown that proper therapy can correct the problem. Not to discount those that suffered sexual abuse as a child, but this is not the same as DID - those children achieve NORMAL childhood integration and probably do not have disorganized attachment problems! This is not the same as DID or even DDNOS or Complex PTSD. I don't know how to better explain this, but false memory ideas should not be addressed here. This is not a concern having to do with DID at all!

There is valid evidence of therapists creating temporary dissociative personality states and I totally believe this should be included in the DID article. I don't know of any expert in the DID area that does not agree with this. At the same time, this type of therapy is no longer used by any ethical practicing therapist today.~ty (talk) 21:49, 7 August 2012 (UTC)

I am glad you asked the questions, but this is not pushing a particular cause of DID! This is what the experts in the field of trauma, the consensus of the EXPERTS think. It is all but a small fringe group that thinks this. Mathew - I thought you were a therapist? You were talking about renewing your CE credits? I am confused. Anyway ---- here is mainstream consensus on how the personality forms, what an ego state is and why only some that are severely abused throughout their entire childhood get DID.~ty (talk) 21:17, 7 August 2012 (UTC)

6th edition of Adult Psychopathology and Diagnosis

Right now the page uses the 5th edition of Adult Psychopathology and Diagnosis 15 times. I just found out that a 6th edition was printed in 2012, with a completely different set of authors writing the chapter on dissociative disorders (Steven Lynn, Joanna Berg, Scott Lilienfeld, Harald Merckelbach, Timo Giesbrecht, Michelle Accardi and Colleen Cleere, see chapter title page [9]). I'm trying to get my hands on a physical copy of the book because google books preview is of the Kindle edition or something, and is harder to link to specific pages. This is a pretty dramatic switch in authorship, as Cardena was far more in the traumagenic camp, while Lynn et al. are mostly authors in the sociocognitive camp. This is a bit of a weird case, both are reliable sources, both represent very different points of view, and I'm expecting the chapters to be substantially different in emphasis, content and criticality. I'm not actually sure what to do - should all the 5th edition references be replaced, can the 5th edition still be used, can we have "competing chapters" used to cite both sides of an issue? I haven't read the chapter yet so all this is somewhat premature, but I do expect this to have a pretty significant impact on the page so - heads' up! WLU (t) (c) Wikipedia's rules:^simple/_complex 19:05, 7 August 2012 (UTC)

• Chapter on Dissociative disorders in general: note the first page explains what I said above about dissociation. The type of dissociation that normal people have is not pathological dissociation - to sum up what they said. They are not saying they don't know what dissociation is.~ty (talk) 22:05, 7 August 2012 (UTC)

• Skipping to where they actually talk about DID. First of all they affirm DID is real. Note there are even tests to measure dissociation. They are not saying anything I have not read numerous times. It is very basic stuff here. Nothing new at all. The free preview quits right in the middle of a discussion Posttraumatic VS Sociocongnivite. There do appear to be a group of researchers from each camp writing the article together. Still nothing new is presented here. It is just a review of the things we know. ~ty (talk) 22:25, 7 August 2012 (UTC)

Great, then there is no issue with using it and replacing the Cardena source. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:33, 7 August 2012 (UTC)

Above there's a link to a google books scan of the physical book [10], that's a bit more useful as you can link directly to pages.

Mathew, I'm not sure why the reflist was added to this section, is it necessary here? Did you want to have one for the page in general? I think there's a way to do it so it isn't archived and it still captures the references. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:38, 7 August 2012 (UTC)

So far WLU it does not matter what I say or do. You simply replace anything and everything you want. Again, I don't have one edit on the DID page that you have allowed to remain. And as for agreeing. There you go doing that thing you do, that I am not allowed to do.~ty (talk) 22:41, 7 August 2012 (UTC)

Why do only some abused children get DID

DID is a valid psychological diagnosis, a mental disorder that is included in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) and the proposed DSM 5 - a serious mental disorder which is at least as common as Schizophrenia. According to the mainstream consensus in psychology today the trauma model is the best model we have and it explains that the sense of self is "built up and synthesized over time. E. Howell adds to this that "the usually presenting part is, by definition, a part in relation to and in relationship with other parts in the total organization of the personality. Today's research in neurobiology, cognitive psychology, and developmental psychology indicates that the brain, the mind, and the self are normally multiple. The brain is organized into "neural system" - these systems "function independently.

• No one is born with one unified self (personality).
• During infancy, behavior is organized as a set of discrete behavioral states (such as deep sleep, awakening, eating) which *link and group together in sequences over time.
• For the natural process of integration to proceed correctly a child must attach to at least one of their primary caregivers.
• All people have multiple states or parts of the self - these parts are called ego states.
• In the healthy mind, a person can switch from ego state to ego state, which is a smooth process that goes without much notice.

Once you understand how the normal process works, then understanding DID is much easier. With the information above in mind, now consider how forming a unitary self can deviate from the norm and cause a major dissociative disorder such as DID.

1. A baby/toddler does not achieve normal attachment due to severe neglect and severe and constant abuse during the earliest years of life. The same baby/toddler cannot achieve normal integration, again due to severe neglect and abuse. The integration should have happened naturally during the earliest years of life but due to trauma it did not happen.

2. Abuse continues throughout this child's life, a child who never achieved normal integration and is suffers from disorganized attachment. This child can become more fragmented.

• So to sum this up DID is believed to be caused by severe terror, starting very early in childhood along with prolonged trauma/stress experienced throughout other important developmental periods of childhood. Alan, R. (2009)

• Sufficient nurturing and compassion in response to overwhelmingly hurtful experiences during childhood is missing as well as extreme ambivalence on the part of caregivers. Gillig, P. (2009)

Though the vast majority of DID cases are caused by child abuse and neglect (by a child's caretakers) this is not always the case. There are accidental ways a child can experience the early childhood trauma of an abused child - such as hospitilazation, an accident, a death, etc..., but still the cause is trauma.

Check list for DID:

• A dissociative capacity (ability to uncouple one's memories, perceptions, or identity from conscious awareness) is high.
• Disorganized attachment and an impeded linkage of behavior states.
• Natural integration which normally occurs during childhood does not take place.
• One cohesive self (with it's many ego states) is not formed.
• Instead of ego states dissociated states (parts) or alters are created.
• To survive some children separate many of their feelings and memories from their usual level of conscious awareness.

Stress and lack of social support from a primary caregiver is experienced in infancy and continues throughout the early years in those with DID. Children have an innate ability to cope using dissociation and are often able to dissociate memories and experiences from consciousness. These memories and feelings they buried - so to say, are later experienced as a separate entity; if the process is repeated numerous times, multiple parts of the self (dissociated parts) may be created.

• Now considered DDNOS. This can occur AFTER SOME NORMAL INTEGRATION has taken place, so the dissociated parts are not alters and they are not ego states... they are something in between.

Does it make sense now? ~ty (talk) 21:17, 7 August 2012 (UTC)

reply to Tylas

No. Please provide sources per WP:MEDRS for all your statements. MathewTownsend (talk) 21:50, 7 August 2012 (UTC)

This is a talk page. You asked a question. I answered.~ty (talk) 21:54, 7 August 2012 (UTC)

Tylas, your continuous response to reasonable requests with "you don't understand". Please note that this is a wikipedia talk page, it is not a soapbox for your personal views and it is not a forum to discuss the diagnosis. Changes must be justified by reference to reliable sources, not statements about the ignorance of other editors. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:31, 7 August 2012 (UTC)

A question was asked. I answered. Geez! I in no way think that Mathew is ignorant! I simply answered the questions he asked.~ty (talk) 22:34, 7 August 2012 (UTC)

'Reply to Mathew': This is just general information. We all know I have no say about what goes into the article, but if you are interested this 2012 article does a good job at answering most of the questions you have. I think to find the basics you would have to dig into books, since research articles assume one knows basics. Howell (2011) probably does the best overall job with explaining the basics in question and her book is simply easy and a delight to read.~ty (talk) 00:24, 9 August 2012 (UTC)

Also for Mathew: While working on another project right now I am digging into current research on DID. I will bring to notice any that I think you might be interested in. Thanks for your continued work on this page.~ty (talk) 00:25, 9 August 2012 (UTC)

Thank you also for continuing to work on our article on DID. However, the study you reference above[11] is a primary source. Please try to follow WP:MEDRS in providing sources, else even the "basics" are not supported. It can't be assumed that the reader knows the "basics" of DID. Also, the definition of DDNOS is incorrect according to the DSM. It isn't a category for those who have have achieved "some normal integration has taken place ..." MathewTownsend (talk) 13:37, 9 August 2012 (UTC)

Reply to Mathew - Thanks again for your patience Mathew. It is hard to work between what IS understood by experts and what is currently in the DSM IV and considered valid for WP. I will quit trying to explain things and just point to the hard facts. Is it Howell's 2011 book that is called a primary source or Ross's book or both? But then what is my purpose here. I am not allowed to edit or educate. It's hopeless here.~ty (talk) 18:50, 9 August 2012 (UTC)

Memory - A few reasons why memory is not an issue with DID and why it should have nothing to do with this page:

• Being a memory researcher doesn't make you an authority on DID.
• Also, the idea that memory is not a tape recorder, that memory has real reliability problems is news only to laypeople. All therapists know this.
• Finally, therapists know that the issue in therapy is the CONTENTS of what the client calls memory, NOT the VERACITY of "memory". Ross has a significant section in his most recent book about the importance of simply accepting what a client says. Getting into any issues of veracity is blatantly off-topic in therapy. "Stay on track. Process the contents of the mind. We cannot really obtain objective verification in most cases anyway. It's not what the memory says to you - it's what it DOES to you, in present time." ~ty (talk) 16:59, 9 August 2012 (UTC)

reply to Tylas

• the many professionals and researchers who compile DSM know more than you do, I hazard to guess, about DID and it diagnosis.
• okay, so "memory" is not an issue with DID, so we should drop the subject of "recovered memory".
• no one thinks that memory is a tape recorder. Elizabeth Loftus demonstrated that what the client calls "memory", and is willing to testify in court to prosecute someone, can be inaccurate. She showed that a few minutes after a man walked through her classroom, her students could not agree whether he was black or white, had a beard or didn't, wore a hat or didn't. So are we saying "memory" is fantasy (the contents of the mind bear no relationship to reality.) So the clinicians job is to process fantasy? And to what does this fantasy relate to? What is the topic, an endless woods of fantasy to figure out what the client's fantasy does to the client?
• so this is the case: "Getting into any issues of veracity is blatantly off-topic in therapy." ok, so helping the client avoid reality is the way to go? Give the client more fantasies and get rid of the fantasies the client calls "memory"?
• how can "integration" take place without memory? How does identity occur without memory?
• have you read WP:MEDRS yet? If so, you can answer your own question about whether the books by Ross and Howell are primary sources or not. Do you know what peer review is?
• please stop assuming that you are the only one that knows anything about DID. It is patronizing to your fellow editors, especially when you can provide no reliable support for your claims. I'm requesting that you stop lecturing me. MathewTownsend (talk) 19:47, 9 August 2012 (UTC)

Information from the ISSTD should be allowed on the DID page

Please provide some reliable sources per WP:MEDRS that state that "Every authority in the field is a member of the ISSTD." This cannot be accepted without multiple reliable sources. MathewTownsend (talk) 13:44, 9 August 2012 (UTC)

Yes, Mathew, you are correct. I did not mean it like that. I rephrased below. Sorry.~ty (talk) 14:47, 9 August 2012 (UTC)

Not to mention I don't think anyone here has ever argued that ISSTD sources or members should be excluded from citation - though Tylas, be aware that your statement gives the appearance of arguing that only ISSTD members should be cited. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:56, 9 August 2012 (UTC)

reply to Tylas

I urge you to maintain good faith and desist from accusing other editors of bad faith such as "twisting things to support your cause." Please be civil to other editors working on this article. We can only work on this article in respectful collegiality, following the WP polices and guidelines, including WP:MEDRS. Please! MathewTownsend (talk) 14:50, 9 August 2012 (UTC)

Reply to Mathew - Okay. I will go and beat up on my Teddy Bear instead. ;) ~ty (talk) 14:53, 9 August 2012 (UTC)

Making my argument more clear: Sorry, I did not present this information correctly late last night. I was in a fog of exhaustion. Let me restate: Information from the ISSTD should be used for the WP DID article because many of the authorities in the field are members and in the past information from the ISSTD has not been allow on the WP DID page which is a clear instance of anti-expert bias. My point is that information from the ISSTD should be allowed to be used on the WP DID page.~ty (talk) 14:47, 9 August 2012 (UTC)

Expertise is determined by publication in reliable sources. The J Trauma Dissociation, which is the ISSTD's primary publication outlet, is a reliable source. However, it is not the only reliable source. The implication that people publishing on the topic are not experts unless members of the ISSTD or publishing in their journal is wrong. One advantage of publishing outside of the J Trauma Dissociation is that the traumagenic position is not assumed or taken for granted as it often is in that particular journal, and in my opinion publications outside of that outlet tend to spend more time dealing with the controversies in ways I find more even-handed. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:49, 9 August 2012 (UTC)

'Reply to WLU' - I never said that the ISSTD is the only reliable site, but in the past you have not allowed any information from the ISSTD to be on the WP DID site - I don't remember the exact words and may look it up but not today, but it was something along the lines of being a biased site. I am not trying to cause waves, I just want to make it clear for future editors that information from the ISSTD will be allowed here, rather than the statements made in the past (as I remember them) are not the rules here.~ty (talk) 16:00, 9 August 2012 (UTC)

To WLU and Mathew - How long have I been trying to edit this page? Looking at the stats they say it has been since 2011-10-15 and in all that time WLU has not allowed one edit to remain, if you exclude one image and the text under another image. That also goes for Tom Cloyd, who was an expert at both DID and WP (even a WP Ambassador). How about Daniel Santos and I am sure many other editors. Not one of our edits has ever been allowed to remain on the WP DID page. Mathew, it's so hard to assume good faith when this is going on for so long. WLU allows you to edit, so you don't feel the frustration, but do understand that many others have and still do! They want to edit, but don't want to deal with this sort of issue.~ty (talk) 16:07, 9 August 2012 (UTC)

reply to Tylas

Please don't go back and edit your comments once others have responded to them, per editing your own comments. It leaves a misleading impression. Readers coming later don't understand all the rewording and deleting you've done, so they won't understand the responses that follow. MathewTownsend (talk) 18:02, 9 August 2012 (UTC)

Before Doc James said to delete such types of posts. I really wish you would all go by the same rules. I added the new edit to the bottom and stated that it was a revised edit, but okay. I will do it one way for you when you are here and another for Doc James when he is here. :( ~ty (talk) 18:09, 9 August 2012 (UTC)

Rind et al.

I don't see the applicability of the Rind et al. controversy here, as far as I can remember none of the articles touched on DID even tangentially. Correct me if I'm wrong. In any case, though it's part of the overall constellation of memory, abuse and dissociation, the current discussion doesn't make the connection clear. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:12, 9 August 2012 (UTC)

It probably isn't directly applicable. It just demonstrates the politics of "child abuse" and how a peer reviewed paper was attacked (even by Congress) because it didn't support the "common knowledge" regarding child sex abuse. MathewTownsend (talk) 13:47, 9 August 2012 (UTC)

I've removed the section, I really don't think it's applicable here, at least in its current version. I've got 9 sources on the topic and I'm going through them. I've found few references to DID; Lilienfeld, 2000 has a brief, irrelevant mention on page 179; Tavris, 2000 has a brief mention on page 16, quoted below:

“ Psychotherapists of all people should welcome further evidence of human resilience. But the religious conservatives who hated the message of the Rind et al. study quickly found support from a group of clinicians who still maintain that childhood sexual abuse causes everything from eating disorders to depression to "multiple personality disorder"; and if depressed adults cannot remember having been sexually abused in childhood, that's all the more evidence that they "repressed" the memory. These ideas have been as discredited by research as the belief that homosexuality is a mental illness or a chosen "lifestyle," but their promulgators cannot let them go. These clinicians want to kill the Rind study because they fear that it will be used to support malpractice claims against their fellow therapists.

Indeed, a group of them, whose members read like a "Who's Who" in the multiple personality disorder and recovered-memories business, made this fear explicit in a memo to the CEO of the American Psychological Association: "In addition to the fact that we, as a group, wish to protect the integrity of psychotherapy, we also want to protect good psychotherapists from attack and from financial ruin as a result of suits that are costly both financially and emotionally." To a casual observer, this concern is a non sequitur; what in the world does a meta-analysis on the long-term effects of childhood sexual abuse have to do with the practice of psychotherapy? Good therapy is still helpful for children and adults suffering from traumatic experiences. But bad therapy, such as that based on unvalidated assumptions that sexual experiences in childhood are invariably traumatizing and commonly "repressed," might indeed be in jeopardy from the meta-analysis. Isn't that important news, especially for "good psychotherapists"?

”

That's it as far as I can see. Tavris might be useful, and does touch on what I personally consider a valid and interesting point about the links between DID and the false/repressed memory debates, but otherwise I can't see a direct enough link to include this much material. I didn't re-read the Rind et al. study itself or the rebuttal they published later (and I couldn't search the text as my copies are pdf images with no character recognition) but I don't recall DID being a substantial point in either one. Can this be sharpened into something that makes the link more obvious and/or direct? WLU (t) (c) Wikipedia's rules:^simple/_complex 17:47, 9 August 2012 (UTC)

(edit conflict)

This isn't what the article is about - as it's about the diagnosis - but I think DID has become so political that there are few sound attempts to understand it. It's like McMartin preschool trial! Entrenched professionals support the diagnosis of DID that has no plausible explanation, except to hearken back to Freud. The paucity of methodologically sound research is astounding, considering the prominence of the diagnosis. It's been around long enough to have prospective studies. To use siblings as "controls" is ridiculous. MathewTownsend (talk) 18:30, 9 August 2012 (UTC)

Incredibly valuable would be a scholarly reference that ties all these threads together into a coherent narrative or study. Sadly, I've never seen such a document (though Paul R. McHugh's Try to Remember came close but wasn't scholarly, and I've heard, but not actually read myself, that Richard Ofshe's Making Monsters comes close - again not scholarly).

I appreciate your sentiment, and you've a point - one we should capture in the page if possible. In fact, I would suggest that this is what makes it so hard to write a good page - extreme disagreement, little high-quality research and a "ten foot pole" sentiment among most professionals. That is the "mood" I would argue the page should convey, though I concede it would be very, very hard to do. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:51, 9 August 2012 (UTC)

No research shows that DID can be created!

"there is no actual research that shows that the complex phenomenology of DID can be created, let alone sustained over time, by suggestion, contagion or hypnosis. Reference: International Society for the Study of Trauma and Dissociation (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, third revision. Journal of Trauma & Dissociation. 12:2, p. 124 Please note the HUGE list of respected researchers in the field of DID that have contributed to this 2011 work and that it is your reference #6 at the moment. ~ty (talk) 13:49, 12 August 2012 (UTC)

THE problems with accurate Dx of DID

This current DID WP page is adding to that confusion presented in the above paragraph. "The difficulties in diagnosing DD result primary from lack of eduction among clinicians about dissociation, DD and the effects of psychological trauma, as well as from clinician bias." Reference: International Society for the Study of Trauma and Dissociation (2011). Guidelines for Treating Dissociative Identity Disorder in Adults, third revision. Journal of Trauma & Dissociation. 12:2, p. 117 Please note the HUGE list of respected researchers in the field of DID that have contributed to this 2011 work. ~ty (talk) 15:16, 12 August 2012 (UTC)

Yes, but that is one view. That is not the definitive answer. As long as you keep insisting on the "rightness" of this organization, this article will get no where. We need a an open minded, knowledge-seeking mentality, not one that "knows" the answers to questions that do not have the solid support of reliable sources. No one organization has all the answers. MathewTownsend (talk) 00:51, 13 August 2012 (UTC)

Just out of curiosity, could you supply a list of DID researchers that oppose the traumagenic position. I cannot find but a few. By the way Mathew, I am sorry that I came off as lecturing, that is not my intent - what I want is to get answers for what is on the DID page. I will reference any material I present on the talk page from now on. I am catching on. Thank you for setting me straight. I will work hard, and never give up until I get this page right for all future editors interested in the subject. ~ty (talk) 01:11, 13 August 2012 (UTC)

Also in reply to your reply, I must disagree Sir. Not the definitive answer? I believe it is Sir. This is THE international association for professionals whose central focus is research and treatment of dissociative disorders. There IS no alternative to the ISSTD. If you know of one, point it out please.

From the ISSTD website:

"The ISSTD is the only international nonprofit professional society that promotes research and training in the identification and treatment of DD and their relationship to developmental, relational, and other traumas. The ISSTD provides a single source for professional and public education and supports international communication and cooperation among professional clinicians and investigators working in the fields of dissociation and trauma."

Reliable sources? Who is more respected and reliable than the list of people who wrote the 2011 guidelines. They include names that are quite well known in the area of DID: Chu, Dell, van der Hart, Cardena, Barach, Somer, Loewenstein, Brand, Golston, Courtois, Bowman, Classen, Dorahy, Sar, Gelinas, Fine, Paulsen, Kluft, Dalenbert, Jacobson-Ley, Nijenhuis, Boon, Chefetz, Middleton, Ross, Howell, Goodwin, Coons, Frankel, Steele, Gold, Gast, Young and Twomby.

I have been reading WP guidelines and if I have this correctly, it is the job of WP to summarize the consensus model of any field, and the ISSTD has done that for us in their guidelines. There is no other consensus. Show me ANY review article that even comes close to competing with this 74 page document. It simply has no competition. A significant number of the people authoring these guidelines are involved in the DSM-5 anxiety, obsessive-compulsive spectrum, posttraumatic, and DD's work group or the research review commissioned by this work group.

Fringe opinions simply are not competitors with the professional consensus, and these people have given us that consensus. That is WP policy.~ty (talk) 01:44, 13 August 2012 (UTC)

"Neutrality also means giving due weight to the different points of view. If the broad scientific community has one set of opinions – then the minority opinion should not be shown." ~ty (talk) 01:49, 13 August 2012 (UTC)

You have not provided a reliable source that "The ISSTD provides a single source for professional and public education and supports international communication and cooperation among professional clinicians and investigators working in the fields of dissociation and trauma." This needs to be cited to sources independent of ISSTD and those associated with it. Using ISSTD to source itself is using a self-published, primary source.

In any case, you have a misunderstanding that "it is the job of WP to summarize the consensus model of any field". Rather, WP should include all various positions, except clearly FRINGE or pseudoscience.

See Autism, for example: "It has long been presumed that there is a common cause at the genetic, cognitive, and neural levels for autism's characteristic triad of symptoms.[61] However, there is increasing suspicion that autism is instead a complex disorder whose core aspects have distinct causes that often co-occur.[61][62]". MathewTownsend (talk) 13:21, 13 August 2012 (UTC)

You may want to read WP:FRINGE a little more closely. None of the people who think DID is iatrogenic or a folie à deux are expressing a fringe theory. The large number of sources that criticize the traumagenic model, all published in peer-reviewed journals or well-respected scholarly press quite clearly indicate that this is not a fringe theory. Your quoting of NPOV is ironic since you seem to think that it means you can remove or downplay the iatrogenesis/SCM opinions, when in fact it insists they be discussed. In fact, Pope et al. 2001, Lalonde et al. 2001 and Pope et al. 2006 suggests that the default position of most professions might be skeptical, and certainly that skepticism is a position held by a significant minority at least. Boysen, 2011 further suggests that the central questions of the professional literature have not been addressed - again arguing against the traumagenic position being the default, majority and consensus one. Assertion isn't the same thing as citation, and citation on wikipedia always wins. WLU (t) (c) Wikipedia's rules:^simple/_complex 18:41, 13 August 2012 (UTC)

Reply: Mathew Sir - DID and Autism are not the same problem. Sociocongnitive is something from the past that is rarely believed in 2012, that is not the problem you present when comparing the 2. I have no issue with a controversy paragraph presenting the sociocongnitive POV and about it being in the history section.~ty (talk) 19:56, 13 August 2012 (UTC)

Reply: WLU Sir, First Boysen's study is about children, it is irrelevant here. Boysen, by the way does not support the sociocognitive POV. The other sources you use - one talks about 1984-2003 - that's a bit old to use here and the other is more than 10 years old - dated 2001. Second, just because YOU strongly believe in the sociocongnitive POV does not mean that the mainstream consensus of experts that study DID do. As for NPOV, it - (per WP guidelines) "indicates the relative prominence of opposing views. Ensure that the reporting of different views on a subject adequately reflects the relative levels of support for those views, and that it does not give a false impression of parity, or give undue weight to a particular view. My source again for mainstream consensus is above - in the 75 page document listed by some of the best and most well-known researchers in the area of DID. Later I will address the problem on this page of using an introductory statement rather than a conclusion when citing a research paper. Eliminating this will clear up most issues on this page.~ty (talk) 19:56, 13 August 2012 (UTC)

Also Sir WLU - Per WP guidelines - "Giving due weight and avoiding giving undue weight means that articles should not give minority views as much of, or as detailed, a description as more widely held views."~ty (talk) 20:07, 13 August 2012 (UTC)

A Solution to the problem - Why not simply keep this article as the mainstream consensus article and make another that shows the minority POVs? That page can be linked to from this page. WP in an encyclopedia and as such should not be adding to confusion about DID, however for those interested in controversy, there should by all means be a page about it. Per WP guidelines - "The article on the Earth does not directly mention modern support for the Flat Earth concept, the view of a distinct minority; to do so would give undue weight to the Flat Earth belief.~ty (talk) 20:10, 13 August 2012 (UTC)

Tylas, have you read WP:NPOV? "Editing from a neutral point of view (NPOV) means representing fairly, proportionately, and as far as possible without bias, all significant views that have been published by reliable sources."

You seem to be suggesting a POV fork, also forbidden by WP:NPOV: "A POV fork is an attempt to evade the neutrality policy by creating a new article about a subject that is already treated in an article, often to avoid or highlight negative or positive viewpoints or facts. POV forks are not permitted in Wikipedia." MathewTownsend (talk) 20:34, 13 August 2012 (UTC)

Reply to Mathew - I just clicked on the POV fork link and was about to read it. Thank you for pointing this out to me. Yes, I am trying to address the NPOV issue here which has been the problem on this page and the reason that for the most part only one editor has ever been allowed to work on this page until now. I like this and could not agree with it more actually! " Articles should not be split into multiple articles just so each can advocate a different stance on the subject." Anyway, there are already several fringe idea pages on DID, another one is certainly not needed. A quick search found [in pop culture], Sybil book, Shirley Mason, Nathan, First person plural, Wilbur, Sybil film, Another Sybil film, Eve, and several other pages touch on the popular media of DID as well such as: mental illness in films, the unexplained, and so on... WP is filled with the pop culture view. ~ty (talk) 20:49, 13 August 2012 (UTC)

The length of a document is obviously irrelevant to its scholarly impact. The Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision has been cited 4 times only, the first edition only six times, and I can't find the second. Your claim that the iatrogenic position is not widely believed in 2012 is flatly wrong, evidenced by the large number of sources that discuss it. If the iatrogenic/SCM position is the minority view, and that's questionable, it is still a substantial one and thus deserves discussion; it is hardly the majority or only position on this page and I have no idea what sections of text your arguments are aimed at removing or shortening. I acknowledge that the sources I cited are old-ish, but there are no comparable sources I am aware of, certainly none indicating the traumagenic position is the mainstream one. Boysen doesn't accept the SC position, but it also doesn't accept the traumagenic. In fact, its core point is that the two positions haven't been sufficiently researched to proclaim one or the other as correct. Which again indicates we shouldn't be deciding on a position to marginalize. My opinion is that both should be present, as should the criticisms of each. We certainly shouldn't mention, then criticize, dismiss and belittle one position in favour of the other. Both mentioned, both discussed, both criticized when reliable sources can be found. I suspect the traumagenic position, as found in ISSTD-published documents, often fails to discuss the other position at all - but if it does, we can certainly include those discussions and criticisms. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:13, 13 August 2012 (UTC)

Reply to WLU - You ignored the fact that the Boysen study was just looking at children, and it's really hard to study children who are in an environment that causes DID. Would you like a reference on this? Also, I searched for Boysen and socicognitive and find nothing except this one study about children. Third, I find a 2012 study that just came out that also reviews children, and also reviews Boysen. All this is still beside the point - because we are not talking children here - after all the sociocongnitive POV tries to maintain that children do not get DID, claiming DID is caused from watching TV, reading books and when one goes to therapy. All 3 references you gave are either older than has been agreed to use on this page or are a review of children. Here is the link (pubmed link) to the new study, although as I said it's about children, so irrelevant to this topic right now and an abstract is not available, but I have not searched for one wider. All authors of this study: Sar, Middleton, Dorahy are listed as authors of the 75 page document cited above so I really doubt they agree with the sociocognitive POV.~ty (talk) 22:36, 13 August 2012 (UTC)

Which article? If it discussed Boysen substantively, I doubt it's a study. If you're talking about Sar et al, that you link to - that is a letter to the editor, rarely considered a WP:MEDRS. But also, I believe I have Boysen's reply to that letter. I'm not sure if we should cite either, but if we do - we must cite both.

Boysen is on children and DID. This is the DID page. There is no page on Children and dissociative identity disorder, and even if there was we would summarize it here. So yeah, we are discussing children. And Boysen's point is that whether children get DID is actually a big deal.

For me the bottom line is, you've made no specific claims on what should be done, so I don't know if you're suggesting something reasonable (like discussing one position a little more or less) or unreasonable (like omitting one position). But bottom line is - your opinion is not sufficient to change the page and you haven't posted any convincing sources that substantiates your rather extreme claims. WLU (t) (c) Wikipedia's rules:^simple/_complex 23:16, 13 August 2012 (UTC)

reply to Tylas

The link you give above "Here is the link (pubmed link) to the new study", is not to a new study but merely to a comment (i.e. opinion) given in response to Boysen's review article. Therefore, it does not meet the requirements of WP:MEDRS. Please read and learn what the requirements are for a reliable source for a medical article and save us all a bunch of trouble. MathewTownsend (talk) 23:20, 13 August 2012 (UTC)

Reply to Mathew - I have read the rules, a few times now and I will keep going through them and reading them as long as I need to.~ty (talk) 23:54, 13 August 2012 (UTC)

p.s. ISSTD is an advocacy organization. MathewTownsend (talk) 23:24, 13 August 2012 (UTC)

Reply to Mathew - I can't tell as I said there is no abstract there and to save trouble and time would have been for WLU to not site a study related to children and 2 more that are old. The ISSTD studies PTSD, DDNOS and other disorders. It is not an organization just made to promote DID. ~ty (talk) 23:49, 13 August 2012 (UTC)

well, I could tell with the same information that you gave. Please take the time to be responsible. This is a big time waste. MathewTownsend (talk) 23:53, 13 August 2012 (UTC)

Reply to Mathew - Why are you even looking at a childhood study. The point is that it has NOTHING to do with the subject we are debating. If you wasted time, that is your own actions, not a fault of mine.~ty (talk) 23:56, 13 August 2012 (UTC)

well, I could tell with the same information that you gave. Please take the time to be responsible. This is a big time waste. Above you misunderstood what DDNOS was. I suggest you stop criticising WLU when you offer no reliable sources but merely make vague criticisms. I think your posts are becoming disruptive. MathewTownsend (talk) 23:53, 13 August 2012 (UTC)

Me? Sir look at yourself. You are attacking me right and left and I don't even care. I am not being disruptive, I am not angry, I am not attacking anyone and I am not criticizing WLU. He argued my post. I argued why his post was incorrect. There was nothing personal there at all. Should I always ignore whatever WLU says (which he has actually been on his best behavior the last couple of days, which I do appreciate! Thank you Sir!) and as usual let him have his way? Look at the history of the DID page. I have only one image on the page and text under another image. The entire page has now been done by you and WLU. Any work I do gets deleted by WLU. How can I be the disruptive one? I should be able to defend the subject at hand. ~ty (talk) 00:11, 14 August 2012 (UTC)

Just to be clear: Here is the title and an abstract is not available. I will take your word for it being a comment and do see something in the citation saying author reply which I did not see at first, but it does say Review in the title. Again - however this is not the topic at hand:

The scientific status of childhood dissociative identity disorder: a review of published research.Sar V, Middleton W, Dorahy MJ.Psychother Psychosom. 2012;81(3):183-4; 185. Epub 2012 Mar 17. ~ty (talk) 00:22, 14 August 2012 (UTC)

Reply to Mathew - Sir, I had to back up here. The entire point of this discussion has been lost and we are debating things that were not even questioned. The topic was the question: is the sociocongnitive POV a fringe or minority POV. Where did we even discuss DDNOS and what does this have to do with what we are talking about? I know quite well what DDNOS, particularly DDNOS-1, but where was this even mentioned on this talk page? I offered a great 2012 source written by (Chu, Dell, van der Hart, Cardena, Barach, Somer, Loewenstein, Brand, Golston, Courtois, Bowman, Classen, Dorahy, Sar, Gelinas, Fine, Paulsen, Kluft, Dalenbert, Jacobson-Ley, Nijenhuis, Boon, Chefetz, Middleton, Ross, Howell, Goodwin, Coons, Frankel, Steele, Gold, Gast, Young and Twomby.) and in return have received the 3 articles we are talking about: review on children does not answer the question: is the sociocognitive POV a minority or fringe POV - especially when the author Boysen did not take either side of the argument and the other 2 papers are historic.~ty (talk) 00:46, 14 August 2012 (UTC)

• To quote you, Tylas (from above): "Now considered DDNOS. This can occur after some normal integration has taken place, so the dissociated parts are not alters and they are not ego states... they are something in between."MathewTownsend (talk) 00:56, 14 August 2012 (UTC)

Reply to Mathew - DDNOS - That is not part of this discussion. You can send me your reasons why this is wrong in private mail so we do not clutter the DID talk page. I would love to talk about this with you!!!!! I have read so much information on this. It is a favorite subject and that you don't agree would make it all the more interesting. You can write me via wikimail. I am excited to talk about this with you!!!! :) Here is a quickie link that will give you a background for this. ~ty (talk) 01:00, 14 August 2012 (UTC)

What topic are we discussing? I thought it was DID.

But overall I agree with Mathew, this is a waste of time. I plan on going with WP:BRD rather than inappropriately debating. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:09, 14 August 2012 (UTC)

DDNOS - Dissociative Disorder Not Otherwise Specified ~ty (talk) 01:19, 14 August 2012 (UTC)

Reply to WLU - You are reverting again whatever you do not agree with and this is just the talk page! Just because it is not your POV does not mean it is wrong. Right now there are 2 editors here that appear to strongly believe in sociocongnitive POV and that just leaves me. Of course a vote would be the 2 of you against me. That does not seem quite right. I looked at the link and there is nothing on it that has anything to do with the question: Is the sociocognitive POV the minority or fringe POV.~ty (talk) 01:22, 14 August 2012 (UTC)

BRD refers to main pages, not talk pages. WLU (t) (c) Wikipedia's rules:^simple/_complex 10:25, 14 August 2012 (UTC)

Official release of DSM-5:: May 18-22, 2013

The 166th APA Annual Meeting in San Francisco, May 18-22, 2013, will mark the official release of DSM-5. DID in the DSM 5 This is just an update of the update. :) ~ty (talk) 23:49, 14 August 2012 (UTC)

I'll believe it when I see it. To say this has been controversial has been an understatement. Casliber (talk · contribs) 01:07, 15 August 2012 (UTC)

Reply to Casliber: Mark your calender Sir! It sounds official! I am excited!!! :) ~ty (talk) 13:34, 15 August 2012 (UTC)

Full free pdf online: 2011 REVISED Adult Guidelines for treating DID

Full free pdf online: International Society for the Study of Trauma and Dissociation (2011). The full pdf is online for free by going to this page and clicking on the orange link - about the middle of the page: Open a copy of the 2011 REVISED Adult Guidelines I gave a link before to this reference, but it was not to a free pdf, but I had the pdf on my desk top, but could not remember where I got it from. I found it, so here is the link to the full article - all 74 pages. This one article answers so many questions that have been presented here. Please everyone, give it a read. Thank you! :) ~ty (talk) 13:30, 15 August 2012 (UTC)

extended discussion on Boysen's article by Tylas at peer review to here

• My thoughts on this study: First it is a lit review. Second, Boysen is saying 93% of the children studied in the literature reviewed were in a clinical setting. I don't see how that small number of clinical subjects can translate to anything in the general population. Third, children outside of a clinical setting are most likely trying to survive in a hostile environment. Fourth, Children are less self aware, and much less verbally expressive than adults, especially when they are being controlled by adults. If they have DID, they are often victims of their parents and children usually generalize the characteristics of their parents to all adults. If parents are not to be trusted, why would adults outside the family be? From the DMS-IV (1994), p. 485 (in the DID section): "In preadolescent children, particular care is needed in making the diagnosis because the manifestations may be less distinctive than in adolescents and adults." Fifth, many of the studies reviewed were prior to a more recent understanding of what DID is, it's symptoms and how to Dx it. The DSM-III, originally published in 1980, formally specified diagnostic criteria for MPD, and every other recognized mental illness. The DSM-III-R (1987) states on p. 271: "Onset of Multiple Personality Disorder is almost invariably in childhood, but most cases do not come to clinical attention until much later." On the same page it also states: "Recent reports suggest that this disorder is not nearly so rare as it has commonly been thought to be." Not until the DSM-IV, in 1994, was there overt recognition in the DSM that DID could be diagnosed in children. Children are addressed in a single sentence (p. 484). Explicit attention is not given to DID in children until the DSM-5, and the exact form it will take is still to be determined. These are just some of the reasons why we don't have more child DID diagnoses. There is much more in my sandbox for those interested. Tylas

• moved here from peer review. MathewTownsend (talk) 19:05, 17 August 2012 (UTC)

Piper & Merskey also discuss children, so I moved some information into that section along with the citation. I'd like to do that with the whole "controversy" section, break it up throughout the appropriate main sections, as its current existence is still a bad idea per WP:STRUCTURE.

I also added a new section on (the lack of) definitions, incorporating information from other sections. I'm pretty sure it can be improved and I'm not sure if there's now duplication or incomplete sections elsewhere in the page, so a review would be good.

Also note that the issue raised with "in children" - basing it on a single citation - is also there with the borderline personality subsection of symptoms. Though in that case it's actually sourced to a multi-author chapter of a textbook. I think there are more citations of this point elsewhere, I haven't turned any up yet but I'm keeping my eyes open. DSM does mention it though, so FWIW I've added it. Found and integrated several more references, so this is addressed.

Regarding Tylas' above comments, personal thoughts and observations are WP:OR and therefore not a reason to change the page. Boysen's overall point isn't to generalize about DID in children, it's to discuss the science to date regarding children and in particular how they illuminate DID as a construct. Citing DSM-III and IV rather than DSM-IV-TR (or DSM-V when it comes out) isn't ideal; IV-TR only discusses children to distinguish symptoms from imaginative play and the absence or possible distortion of childhood biographical memories (my DSM preview cuts out at 529 though, I'll try to check that page tomorrow). WLU (t) (c) Wikipedia's rules:^simple/_complex 00:09, 18 August 2012 (UTC)

What happened to waiting for the peer review comments before moving forward? Are we back to debating this, or are we waiting. Please cite references, not your POV. Tanya~talk page 00:41, 18 August 2012 (UTC) This is a zoo! No more editing needs to be done without our peer reviewer here. Tanya~talk page 05:00, 18 August 2012 (UTC)

Also, why is it that if I edit, it gets reverted, but WLU can edit away as he wants? Please show current review articles for this section, or wait for the peer review to give his advice. Tanya~talk page 00:42, 18 August 2012 (UTC)

because WLU doesn't edit from personal opinion and uses reliable sources. . MathewTownsend (talk) 01:06, 18 August 2012 (UTC)

So you are saying that is what I do and why I am not allowed to edit this page? You don't call WLU's POV diff that people with DID actually have multiple personalities a POV? You keep attacking me and this is the reason you give? Tanya~talk page 01:09, 18 August 2012 (UTC)

Reply to Mathew - You do get that WLU is cherry picking information. The consensus model of the profession CANNOT be reflected in cherry picked citations. Tanya~talk page 02:46, 18 August 2012 (UTC)

Please Sir, show me the valid references for the section he wrote about children and DID. Tanya~talk page 01:12, 18 August 2012 (UTC)

That would be Boysen, 2011 and Piper & Merskey, 2004. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:02, 18 August 2012 (UTC)

These are not POV's: The reference is the DSM and even the page numbers are given. The DSM-III, originally published in 1980, formally specified diagnostic criteria for MPD, and every other recognized mental illness. The DSM-III-R (1987) states on p. 271: "Onset of Multiple Personality Disorder is almost invariably in childhood, but most cases do not come to clinical attention until much later." On the same page it also states: "Recent reports suggest that this disorder is not nearly so rare as it has commonly been thought to be." Not until the DSM-IV, in 1994, was there overt recognition in the DSM that DID could be diagnosed in children. Children are addressed in a single sentence (p. 484). Explicit attention is not given to DID in children until the DSM-5, and the exact form it will take is still to be determined. Tanya~talk page 01:29, 18 August 2012 (UTC)

Why would we cite, or even discuss, DSM-III when DSM-IV-TR is the most recent DSM and DSM-V is coming out? It's not relevant bar historical information. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:02, 18 August 2012 (UTC)

Reply to WLU - Please cite exactly what Piper and Mersky say about children, is it even relevant here - and this Piper & Merskey paper is the one that Ross, a giant in this area of study, [(http://www.ncbi.nlm.nih.gov/pubmed/19306208 Ross citation]) reviewed and said "The two papers contain errors of logic and scholarship. Contrary to the conclusions in the critique, DID has established diagnostic reliability and concurrent validity, the trauma histories of affected individuals can be corroborated, and the existing prospective treatment outcome literature demonstrates improvement in individuals receiving psychotherapy for the disorder." I know we have gone over this already before in the talk pages. As for the Boysen, it does not mention anything you have written in his abstract and certainly has not in his conclusion. The study gives no preference. I have posted the conclusion and don't see the need to take up space again. Also should we use the DSM 5 or not. I keep getting 2 different stories here. I don't care either way, but stick to one way. I do prefer to use the newest and best information out there, so I do vote for using the proposed DSM 5.Tanya~talk page 01:49, 18 August 2012 (UTC)

In Piper & Merskey, 2004, The Persistence of Folly: A Critical Examination of Dissociative Identity Disorder. Part I. The Excesses of an Improbable Concept, children are discussed on page 596, in the brief section "The Rarity of DID in Children". It's a full text PDF, you can read it yourself for free by clicking on the link. It's not a study, it's a review article, thus a secondary MEDRS, and Ross' criticisms are also discussed (though I find them extremely weak). What specific points in the article that are cited to Boysen do you think are not verified?

When DSM-V comes out we can certainly mention it, though I would argue that a discussion of DSM-IV would have to remain, perhaps abbreviated, for a while since much of the recent literature is based on it. But we'll see, I didn't think removing the section on DSM-V was a good idea in the first place - though since it's still prospective I can see why removing it is defensible. Perhaps an abbreviated version would be acceptable. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:02, 18 August 2012 (UTC)

No Sir, it's old. We know there is problems with the old literature. This page is not a debate between history and current knowledge. Citations should be no more than 5 years old. I will read the paper, but it's still history, not the current consensus of mainstream experts on DID. Tanya~talk page 02:06, 18 August 2012 (UTC)

Boysen - I pointed them out step by step here. Tanya~talk page 02:11, 18 August 2012 (UTC)

Piper and Merskey - read page 529. The little paragraph that even mentions children talks about cases prior to 1993. That is historic. Please cite current information. Tanya~talk page 02:19, 18 August 2012 (UTC)

I did, Boysen, 2011. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:27, 18 August 2012 (UTC)

Incidentally, Ross' reply to Piper & Merskey didn't actually discuss childhood DID. He talked about childhood trauma and abuse a lot, but looking at all the instances where "child" appeared in the article, I didn't see any discussion of children diagnosed with DID. It was a quick skim, I could be wrong - I wanted to add it to the "on children" section but didn't because as far as I can tell there's no mention. WLU (t) (c) Wikipedia's rules:^simple/_complex 02:37, 18 August 2012 (UTC)

What does this have to do with anything? Tanya~talk page 02:53, 18 August 2012 (UTC)

You mentioned Ross above. It's only tangentially related to the topic, which is why I started my comment with "incidentally".

How am I cherry-picking? I'm relying on peer-reviewed, secondary sources - review articles published in good journals - published by psychiatrists, psychologists and related experts. I'll admit I spend more time on the iatrogenic hypothesis, but then again you constantly challenge that model. I look up sources to address your criticisms, I find them fairly easily, and I add them to the page. Because I have limited time I don't end up spending as much time reading up on the traumagenic side. That aspect of the page should be expanded as well, I just don't happen to be doing it. My preferred way to address claims that my edits are undue weight is to find as many sources as I can that demonstrate my edits are supported by reliable, scholarly sources. It's a pretty good way of doing things, one that directly addresses NPOV's statement that weight is demonstrated through sources, not editor assertion.

The accusation of cherry-picking is an unpleasant one given the amount and quality of sources I use. Please note that I am not happy that I have to defend my edits yet again, despite the number and quality of sources that support them. WLU (t) (c) Wikipedia's rules:^simple/_complex 03:03, 18 August 2012 (UTC)

Sir, I have never been able to actually work on the DID page, any work I do you revert. You have not defended them from me. I am isolated to the talk page. You pick articles that you feel will support your minority POV and you take the introduction from articles that argue your POV and use them as a reference to support your POV. I do not challenge the model. The mainstream consensus of experts in the field of DID challenge the model. pdf file (p.122-124) Tanya~talk page 03:46, 18 August 2012 (UTC)

You see isolation on the talk page, I see a failure to garner consensus for your edits and opinions. For instance, the opinion that "my" POV is a minority one - this is questionable considering the number of source that support it. And even if it were a minority opinion, it is certainly a substantial, well-documented and highly reliable one (more accurately, a large number of sources that discuss and elaborate on it). The idea that there is a mainstream consensus of experts rather than a bitterly divided scholarly topic again seems like an opinion rather than a fact. Certainly the traumagenic hypothesis is one notable opinion, but it is not the only one and it is not so overwhelming that other opinions should be eliminated.

So WP is not about mainstream consensus of the experts on DID it is about you taking the side of the minority POV of DID against me. There is something really wrong here. The WP page is not what you or I want. It's suppose to reflect the mainstream consensus of the experts in DID. pdf file (p.122-124) Tanya~talk page 04:56, 18 August 2012 (UTC)

If I have mis-represented a source, please name the source and explain how it is badly summarized. There's a good chance you are right, I do edit quickly and many sources are skimmed rather than read in detail. WLU (t) (c) Wikipedia's rules:^simple/_complex 03:55, 18 August 2012 (UTC)

I have many times and it gets ignored by you. pdf file (p.124) For the last please see the Boysen and Piper papers. You are being nice again. I like that. :) Thank you!!!! Tanya~talk page 04:04, 18 August 2012 (UTC)

Again, as I say below, feeling the need to point out that I'm "now" being nice irritates me as it comes across as quite condescending. Please don't bother, please comment on content.

That is your POV. It was a truly genuine gesture. Tanya~talk page 04:52, 18 August 2012 (UTC)

You asked where Piper & Merskey discuss children. I linked to the article, noted the page and the section title. That's not ignoring you. Your rebuttal appeared to be that their citations were too old. That's discounting a source based on your own opinion, you'd need consensus for that. As for P&M itself being too old, that's a subject for discussion; though relatively old, it's also relatively classic, neatly summarizes the critical position, and has a fair number of citations. It's the kind of thing that could be kicked to the reliable sources noticeboard. But I don't believe it is badly summarized, I'd have to see a juxtaposition of the uses on the page and what is objectionable to comment further.

Boysen is a recent review article on DID in children - their importance to the theoretical questions of diagnosis. You don't seem to say much about Boysen beyond that you haven't read it, both on this talk page and on your subpage discussion where you mostly note that the statements it verifies are not discussed in the abstract or conclusion. I would therefore suggest they are discussed in the body. You can verify independently if you get a copy. WLU (t) (c) Wikipedia's rules:^simple/_complex 04:48, 18 August 2012 (UTC)

Where Piper and Merskey talk about children as in saying what is in the DID WP article since you just added that reference to that paragraph. Tanya~talk page 04:52, 18 August 2012 (UTC)

I don't understand what you are asking here. WLU (t) (c) Wikipedia's rules:^simple/_complex 04:55, 18 August 2012 (UTC)

Tylas, interstitching comments like you do here really makes it difficult to follow the discussion. Responding to your substantive point, it is predicated on the assertion that your opinions represent the mainstream consensus of experts on DID. I do not believe you have backed up this assertion, and in fact the number and publication views of those who explicitly disbelieve the traumagenic hypothesis suggests, as I have said before, that either the traumagenic hypothesis is not the mainstream view, or that there is a substantial minority of scholars publishing their doubts in peer reviewed journals - and therefore discussion of their points on this page is perfectly legitimate. WLU (t) (c) Wikipedia's rules:^simple/_complex 05:04, 18 August 2012 (UTC)

Reply to my "substantive point" - I am working on it in this sandbox since we have done this numerous times, I would like it one place so I don't have to keep redoing the work. This will take a while. There is about 72 pages or so just in the one 2011 Review article pdf file I address there, so be patient. When our peer review has time to catch up this his other concerns then we can address this. We should not be overwhelming him when he has made it clear he is busy and traveling. Thank you team. Of course when our peer reviewer is ready, then we can move the points here that need to be discussed further. Acceptable? Tanya~talk page 18:04, 18 August 2012 (UTC)

Basing the entire page on a single article, no matter how long, is inappropriate - particularly when it is quite partisan and assumes one view is correct. Making the page reflect the POV in that article as if it were the mainstream scientific consensus when it hasn't been demonstrated that the traumagenic view is the mainstream POV is also incorrect. You are mistaking a view you agree with, and a view that contains no dissenting discussion, with the right view. As I've said many times, the number and quality of sources discussing the non-traumagenic position indicates it is, at least, a substantial minority within the field and therefore deserves a serious, not dismissive, discussion. That being said, the ISSTD's guidelines can and should be used in the page itself. WLU (t) (c) Wikipedia's rules:^simple/_complex 13:23, 19 August 2012 (UTC)

Reply to WLU - You are so caught up in your own fringe POV that you will not look at the facts Sir. What you accuse me of is what you are doing, not me. Your POV is something to the effect that watching TV and reading a book causes DID - but as I have repeatedly pointed out there is NO research to back up your claim. pdf file (p.124) With no research support, any alternative ideas are just speculations. Personally, I think the most plausible alternative to trauma is infection of neural tissue by space aliens, but so far no one has taken me seriously. Crushing, that. I will answer more of this below in the section: main controversy on the DID page. Tanya~talk page 15:43, 19 August 2012 (UTC)