A Study on Dissociative Identity Disorder in Japan
A Study on Dissociative Identity Disorder in Japan
Issue Date
2003
Authors
Malcolm, Lindsay A.
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Abstract
The study of dissociative identity disorder (DID) has found that it is a worldwide phenomenon. Still, little research has been conducted to identify the differences in its presentation in other cultures. This study analyzed 12 cases of DID from Japan, a modern but socio-centric society in which maintaining harmony is a prime concern. This study aimed to gain a deeper understanding of DID by examining its presentation and suspected etiology in another culture using content analysis. The specific areas analyzed are the nature of trauma experienced, suspected etiology of the disorder, characteristics of the host and altered personalities, factors contributing to alter creation, triggers to switching, circumstances surrounding the onset of treatment, symptoms and diagnosis, histrionic and antisocial personality traits, and posttraumatic and somatoform symptomatology. There was a marked absence of physical and sexual abuse in the histories of the Japanese clients. Also noticeable was that the onset and course of the disorder in Japan may better be described as acute rather than chronic. Further, there appeared to be less comorbid substance abuse or antisocial behavior. In keeping with the cultural emphasis on self-control, histrionic and antisocial acting out seemed to act as a catalyst for families to urge treatment. Additionally, there were significantly fewer alters in the Japanese cases than reported in North American studies. The findings demonstrate that, although DID is a reality in Japan, the underlying trauma and the resulting symptom pattern are different. While the etiology and presentation of the disorder in Japan contrast with its etiology and presentation in North America, they are, nevertheless, consonant with Japanese self-construal. The author questions the efficacy of using disease-centered diagnostic criteria when the signs and symptoms are culturally mediated.