Kontroverza disocijativnog poremećaja identiteta

Kontroverza disocijativnog poremećaja identiteta

Sažetak

Spektar disocijativnih poremećaja (DD) i danas predstavlja kontroverzno područje brojnih neslaganja u pogledu definiranja DD-a, njihove dijagnoze i tretmana pri čemu je kompleksnost tih pitanja najveća u slučaju disocijativnog poremećaja identiteta (DID). U početnom dijelu ovoga radu, u okviru biopsihosocijalnog modela, prikazani su etiološki čimbenici razvoja DID-a: razvojna traumatizacija kao najvažniji faktor, zatim utjecaj obitelji, društva i kulture i na koncu kognitivni i neuralni čimbenici. Nadalje, u središnjem dijelu rada objašnjeno je s kojim je poremećajima DID najčešće u komorbiditetu te je detaljnije razmotrena njihova diferencijalna dijagnoza s naglaskom na shizofreniju i granični poremećaj ličnosti. Iako neki znanstvenici i dalje osporavaju DID kao validnu dijagnozu, u radu su opisani instrumenti pomoću kojih se DID može valjano i pouzdano razlikovati od ostalih poremećaja. Zaključno, u završnom dijelu predstavljene su mogućnosti tretmana DID-a s naglaskom na fazični model, osmišljen prema preporukama stručnjaka koji se za sada pokazao djelotvornim i obećavajućim. Sukladno rečenome, cilj je ovoga rada napraviti pregled istraživanja etiologije, dijagnoze i tretmana DID-a koji bi pridonio razjašnjavanju
do danas aktualne kontroverze postojanja i validnosti ovog poremećaja.

Ključne riječi: disocijativni poremećaji, disocijativni poremećaj identiteta

Abstract

The spectrum of dissociative disorders (DD) still represents a controversial area of numerous
disagreements regarding the definition of DD, their diagnosis and treatment. The complexity
of these issues is greatest in the case of dissociative identity disorder (DID). The opening part of this paper considers the etiological factors of this disorder, presented within the context of the biopsychosocial model: developmental traumatization as the most important factor, then the influence of the family, society and culture and finally, cognitive and neural factors. Furthermore, the central part of the paper explains what other disorders are most frequently comorbid with DID and describes their differential diagnosis, primary schizophrenia and borderline personality disorder. Although some scientists still refuse to regard DID as a valid diagnosis, this paper describes the instruments which can validly and reliably distinguish DID from other disorders. In the final part, various possibilities of DID treatment are presented with an emphasis on the phase model, which was designed according to the recommendations of experts and has proven to be effective and promising so far. Accordingly, the aim of this paper is to provide a review of the research concerning etiology, diagnosis and treatment of DID, which would contribute to the clarification of the current controversy regarding the existence and validity of this disorder.

Key words: dissociative disorders, dissociative identity disorder

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