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Concept: Dissociation

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Despite increasing interest in pathological and non-pathological dissociation, few researchers have focused on the spiritual experiences involving dissociative states such as mediumship, in which an individual (the medium) claims to be in communication with, or under the control of, the mind of a deceased person. Our preliminary study investigated psychography - in which allegedly “the spirit writes through the medium’s hand” - for potential associations with specific alterations in cerebral activity. We examined ten healthy psychographers - five less expert mediums and five with substantial experience, ranging from 15 to 47 years of automatic writing and 2 to 18 psychographies per month - using single photon emission computed tomography to scan activity as subjects were writing, in both dissociative trance and non-trance states. The complexity of the original written content they produced was analyzed for each individual and for the sample as a whole. The experienced psychographers showed lower levels of activity in the left culmen, left hippocampus, left inferior occipital gyrus, left anterior cingulate, right superior temporal gyrus and right precentral gyrus during psychography compared to their normal (non-trance) writing. The average complexity scores for psychographed content were higher than those for control writing, for both the whole sample and for experienced mediums. The fact that subjects produced complex content in a trance dissociative state suggests they were not merely relaxed, and relaxation seems an unlikely explanation for the underactivation of brain areas specifically related to the cognitive processing being carried out. This finding deserves further investigation both in terms of replication and explanatory hypotheses.

Concepts: Pseudoscience, Single photon emission computed tomography, Dissociation, Spiritualism, Mediumship, Spiritism, Trance, Cerebrum

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INTRODUCTION AND AIMS: As in many cultures, spirit possession is a common idiom of distress in Uganda. The DSM-IV contains experimental research criteria for dissociative and possession trance disorder (DTD and PTD), which are under review for the DSM-5. In the current proposed categories of the DSM-5, PTD is subsumed under dissociative identity disorder (DID) and DTD under dissociative disorders not elsewhere classified. Evaluation of these criteria is currently urgently required. This study explores the match between local symptoms of spirit possession in Uganda and experimental research criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. METHODS: A mixed-method approach was used combining qualitative and quantitative research methods. Local symptoms were explored of 119 spirit possessed patients, using illness narratives and a cultural dissociative symptoms' checklist. Possible meaningful clusters of symptoms were inventoried through multiple correspondence analysis. Finally, local symptoms were compared with experimental criteria for PTD in the DSM-IV and proposed criteria for DID in the DSM-5. RESULTS AND CONCLUSION: Illness narratives revealed different phases of spirit possession, with passive-influence experiences preceding the actual possession states. Multiple correspondence analysis of symptoms revealed two dimensions: ‘passive’ and ‘active’ symptoms. Local symptoms, such as changes in consciousness, shaking movements, and talking in a voice attributed to spirits, match with DSM-IV-PTD and DSM-5-DID criteria. Passive-influence experiences, such as feeling influenced or held by powers from outside, strange dreams, and hearing voices, deserve to be more explicitly described in the proposed criteria for DID in the DSM-5. The suggested incorporation of PTD in DID in the DSM-5 and the envisioned separation of DTD and PTD in two distinctive categories have disputable aspects.

Concepts: Dissociative identity disorder in popular culture, Mental disorder, Schizophrenia, Dissociation, Research, Quantitative research, Qualitative research, Dissociative identity disorder

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AIMS: To review the recreational use of ketamine (“Special K”; KET) and explore the recent diffusion of its new derivative methoxetamine (“Special M”; MXE). METHODS: The literature search on the nonclinical/recreational use of KET and MXE was carried out in a range of medical databases. Considering the limitations of peer-reviewed information, data were integrated with a qualitative assessment of a range of websites, drug fora, and other online resources including e-newsgroups, chat rooms, mailing lists, e-newsletters, and bulletin boards. RESULTS: The recreational use of KET has started since its discovery in 1962. This was due to its rapid onset, short duration of action, and peculiar psychotropic effects (“K-hole”). The latter effect ranges from confusion to dissociation and depersonalization (near-death experience). However, KET abuse is often associated with physical and psychological side effects, of which the worst is urological/bladder toxicity. Recently, MXE has emerged as a legal and “bladder-friendly” KET alternative. MXE presents with the same dissociative effect of KET, but with slower onset and longer duration of action. However, MXE seems to be associated with worse side effects than KET, ranging from mood disturbances/suicidal attempts to acute cerebellar toxicity. CONCLUSIONS: After 50 years of its discovery, KET has led to the emergence of MXE. However, this latter derivative does not appear to be a safer alternative to KET itself.

Concepts: K-hole, Opioid, Psychoactive drug, Dextromethorphan, Dissociation, Near death experience, Recreational drug use, Ketamine

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Benazepril, an anti-hypertensive drug, was subjected to forced degradation studies. The drug was unstable under hydrolytic conditions, yielding benazeprilat, which is a known major degradation product (DP) and an active metabolite. It also underwent photochemical degradation in acid and neutral pH conditions, resulting in multiple minor DPs. The products were separated on a reversed phase (C18) column in a gradient mode, and subjected to LC-MS and LC-NMR studies. Initially, comprehensive mass fragmentation pathway of the drug was established through support of high resolution mass spectrometric (HR-MS) and multi stage tandem mass spectrometric (MS(n)) data. The DPs were also subjected to LC-MS/TOF studies to obtain their accurate masses. Along with, on-line H/D exchange data were obtained to ascertain the number of exchangeable hydrogens in each molecule. LC-(1)H NMR and LC-2DNMR data were additionally acquired in a fraction loop mode. The whole information was successfully employed for the characterization of all the DPs. A complete degradation pathway of the drug was also established.

Concepts: Fragmentation, Multiplication, Force, Dissociation, Prodrugs, PH, Mass, Mass spectrometry

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The purpose of this study was to assess the scientific and etiological status of dissociative identity disorder (DID) by examining cases published from 2000 to 2010. In terms of scientific status, DID is a small but ongoing field of study. The review yielded 21 case studies and 80 empirical studies, presenting data on 1171 new cases of DID. A mean of 9 articles, each containing a mean of 17 new cases of DID, emerged each year. In terms of etiological status, many of the central criticisms of the disorder’s validity remain unaddressed. Most cases of DID emerged from a small number of countries and clinicians. In addition, documented cases occurring outside treatment were almost nonexistent. Finally, people simulating DID in the laboratory were mostly indistinguishable from individuals with DID. Overall, DID is still a topic of study, but the research lacks the productivity and focus needed to resolve ongoing controversies surrounding the disorder.

Concepts: 0, Mental disorder, Empirical, Dissociation, Dissociative identity disorder in popular culture, Research, Dissociative identity disorder, Scientific method

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Dissociative identity disorder (DID), once considered rare, was frequently diagnosed during the 1980s and 1990s, after which interest declined. This is the trajectory of a medical fad. DID was based on poorly conceived theories and used potentially damaging treatment methods. The problem continues, given that the DSM-5 includes DID and accords dissociative disorders a separate chapter in its manual.

Concepts: Trajectory, Trajectory of a projectile, Dissociative disorders, Iatrogenesis, Dissociation, Dissociative identity disorder, Mental disorder

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Abstract Psychologists have long assumed a connection between traumatic experience and psychological dissociation. This hypothesis is referred to as the Trauma Model of dissociation. In the last decade, a series of papers have been published that question this traditional causal link, proposing an alternative Fantasy Model of dissociation. In this research, the relationship among dissociation, suggestibility, and fantasy proneness were examined. Suggestibility was measured through the Gudjonsson Scale of Interrogative Suggestibility (GSS), as well as an autobiographically based version of this measure based on the events of September 11, 2001. Consistent with prior research and with the Trauma Model, dissociation correlated positively with trauma severity (r = .32, p < .01) and fantasy proneness (r = .60, p < .01). Inconsistent with the Fantasy Model, dissociation did not correlate with the neutral form of the Gudjonsson, and correlated negatively (r = -.24, p < .05) with the trauma-focused form of this suggestibility measure. Although some participants did become quite emotional during the procedure, the risk/benefit ratio was perceived by almost all participants to be positive, with more reactive individuals evaluating the procedure more positively. The results consistently support the Trauma Model of dissociation and fail to support the Fantasy Model of dissociation.

Concepts: September 11, Measurement, First-order logic, Gödel's incompleteness theorems, Metalogic, Psychological trauma, Dissociation, Psychology

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Couple therapy in the context of dissociative identity disorder (DID) has been neglected as an area of exploration and development in the couple therapy and trauma literature. What little discussion exists focuses primarily on couple therapy as an adjunct to individual therapy rather than as a primary treatment for couple distress and trauma. Couple therapy researchers have begun to develop adaptations to provide effective support to couples dealing with the impact of childhood trauma in their relationships, but little attention has been paid to the specific and complex needs of DID patients in couple therapy (H. B. MacIntosh & S. Johnson, 2008 ). This review and case presentation explores the case of “Lisa,” a woman diagnosed with DID, and “Don,” her partner, and illustrates the themes of learning to communicate, handling conflicting needs, responding to child alters, and addressing sexuality and education through their therapy process. It is the hope of the author that this discussion will renew interest in the field of couple therapy in the context of DID, with the eventual goal of developing an empirically testable model of treatment for couples.

Concepts: Psychology, Process, Personality psychology, Sexual abuse, Mental disorder, Scientific method, Dissociation, Dissociative identity disorder

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Dissociative identity disorder (DID) is a disputed psychiatric disorder. Research findings and clinical observations suggest that DID involves an authentic mental disorder related to factors such as traumatization and disrupted attachment. A competing view indicates that DID is due to fantasy proneness, suggestibility, suggestion, and role-playing. Here we examine whether dissociative identity state-dependent psychobiological features in DID can be induced in high or low fantasy prone individuals by instructed and motivated role-playing, and suggestion.

Concepts: Dissociation, Family therapy, Psychiatry, Schizophrenia, Psychology, Dissociative identity disorder, Mental disorder