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562 CHAPTER 13 Psychological DisordersHerschel Walker and Dissociative IdentityDisorder As a professional football player,Walker (2008) was somewhat of anenigma to his teammates because of hisdiverse pursuits, which ranged from bobsleddingto ballet dancing, and because heoften referred to himself in the third person.“Herschel played well today,” hemight say. After retiring from football,Walker began suffering from unexplainedviolent outbursts, black-outs, and memoryloss. Since being diagnosed with dissociativeidentity disorder, Walker has identifieda dozen distinct alters, including “TheWarrior” who handled playing footballand the pain that went with it, and “TheHero” who made public appearances.With therapy, Walker is learning to managehis disorder and hopes to educate thepublic about this rare disorder.schizophreniaA psychological disorder in which the abilityto function is impaired by severely distortedbeliefs, perceptions, and thought processes.positive symptomsIn schizophrenia, symptoms that reflect excessesor distortions of normal functioning,including delusions, hallucinations, and disorganizedthoughts and behavior.negative symptomsIn schizophrenia, symptoms that reflect defectsor deficits in normal functioning, includingflat affect, alogia, and avolition.delusionA falsely held belief that persists despitecompelling contradictory evidence.Symptoms of amnesia and memory problems are reported in virtually all casesof DID. There are frequent gaps in memory for both recent and childhood experiences.Commonly, those with dissociative identity disorder “lose time” andare unable to recall their behavior or whereabouts during specific time periods.In addition to their memory problems, people with DID typically have numerouspsychiatric and physical symptoms, along with a chaotic personal history(Cardena & Gleaves, 2007). Symptoms of major depression, anxiety, post-traumaticstress disorder, substance abuse, sleep disorders, and self-destructive behavior arealso very common. Often, the DID patient has been diagnosed with a variety ofother psychological disorders before the DID diagnosis is made (Gleaves &others, 2003).Not all mental health professionals are convinced that dissociative identity disorderis a genuine psychological disorder (Cardena & Gleaves, 2007; Leonard & others,2005; Piper & Merskey, 2004). For example, a survey by Justine Lalonde andhis colleagues (2001) found that fewer than 1 in 7 American and Canadian psychiatristsfelt that diagnoses of dissociative disorders were supported by strong scientificevidence. Much of such skepticism is related to the fact that the number of reportedcases of DID was extremely low, then suddenly surged in the early 1970s aftermovies and books about multiple personality disorder were featured in the popularmedia. As psychologist John Kihlstrom (2005) noted, not only the number of casesbut also the number of “alters” showed a dramatic increase. To some psychologists,such findings suggest that DID patients learned “how to behave like a multiple”from media portrayals of sensational cases or by responding to their therapists’ suggestions(Gee & others, 2003). On the other hand, DID is not the only psychologicaldisorder for which prevalence rates have increased over time. For example, ratesof obsessive–compulsive disorder and PTSD have also increased over the past fewdecades, primarily because mental health professionals have become more aware ofthese disorders and more likely to screen for symptoms (Gleaves, 1996). The dissociativedisorders are summarized in Table 13.8 on page 560.Explaining Dissociative Identity DisorderAccording to one explanation, dissociative identity disorder represents an extremeform of dissociative coping (Moscowitz & others, 2009). A very high percentage ofDID patients report having suffered extreme physical or sexual abuse in childhood—over 90 percent in most surveys (Foote & others, 2006; Sar & others, 2007). Accordingto this explanation, to cope with the trauma, the child “dissociates” himselfor herself from it, creating alternate personalities to experience the trauma.Over time, alternate personalities are created to deal with the memories and emotionsassociated with intolerably painful experiences. Feelings of anger, rage, fear, andguilt that are too powerful for the child to consciously integrate can be dissociatedinto these alternate personalities. In effect, dissociation becomes a pathological defensemechanism that the person uses to cope with overwhelming experiences.Although widely accepted among therapists who work with dissociative identitydisorder patients, the dissociative coping theory is difficult to test empirically. Oneproblem is that memories of childhood are notoriously unreliable. Since DID is usuallydiagnosed in adulthood, it is very difficult, and often impossible, to determinewhether the reports of childhood abuse are real or imaginary.Another problem with the “traumatic memory” explanation of dissociative identitydisorder is that just the opposite effect occurs to most trauma victims—they arebothered by recurring and intrusive memories of the traumatic event. For example,in a study by Gail Goodman and her colleagues (2003), more than 80 percent ofyoung adults with a documented history of childhood sexual abuse remembered theabuse. Of those who didn’t report the abuse, reluctance to disclose the abuse andbeing too young to remember the abuse seemed to be the most likely explanations.Although the scientific debate about the validity of the dissociative disorders is likelyto continue for some time, the dissociative disorders are fundamentally differentfrom the last major category of disorders we’ll consider—schizophrenia.