Child Sexual Abuse Goes Vastly Under Reported

Child Sexual Abuse Goes Vastly Under Reported

By Joanna M. Doane
March 14, 2007

INTRODUCTION

Sexual abuse of a child is defined as inappropriately exposing or subjecting a child to sexual contact, activity, or behavior, and occurs when a child is used for gratification of adult sexual desires. Within the past decade research has shown that there is a marked under estimation in the prevalence of child sexual abuse, which currently is reported by 20 percent of women and 5 to 10 percent of men worldwide. According to University of Oregon psychologist, Jennifer Freyd, an authority on trauma, although official reports of child sex abuse have declined somewhat in the U.S. during the last 10 years, close to 90 percent of sexual abuse cases are never reported to authorities. Despite such findings, the public’s awareness of childhood sexual abuse within the U. S. has still greatly improved within the past three decades. Today, interest in the problem of child sexual abuse is greater than ever before. Psychiatrist, Jon R. Conte, Ph.D., points out that l andmark documents such as S. Butler’s “Conspiracy of Silence: The Trauma of Incest” (1978), and F. Rush’s “The Best Kept Secret: Sexual abuse of children” (1980) were followed by countless stories about sexual abuse in the print and electronic media, by an explosion in research and other scholarship in the social and behavioral sciences, and by increased attention from health, mental health, social service, and legal professionals. If such efforts to educate, study, and speak out about childhood sexual abuse continue by abuse prevention organizations, researchers, and child advocates then this upward spiral of awareness should hopefully likewise continue.

Although there are many possible causes for the under reporting of child sexual abuse within the U. S., this report will focus on the following three: (1) the under educating of America's youth about reporting experienced abuse; (2) continual public ignorance and reluctance in identifying and reporting suspected abuse; and (3) greater public understanding of the societal consequences child sexual abuse equally imposes on all of the U. S. as a whole.

DATA SECTION

Most often children are not adequately educated in age-appropriate language about the importance of reporting experienced sexual abuse. Often children will keep abuse a secret because they don't have the language to describe it, or because they don't think anyone will believe them. Compounding this problem is the closeness that most perpetrators have with their victims. Surveys suggest that 13 percent of women were forced into sexual contact with an adult male during their childhood, many of them by their fathers or step fathers (Hill, 2003). To keep the abuse a secret, perpetrators often blame and threaten their victims, at times telling them that if they do tell they will not be believed. In response to this problem, educators and physicians have launched early detection programs that aim to 1) educate all children about child sexual abuse; 2) teach them skills for avoiding or escaping abusive situations; 3) encourage children to tell another adult if they are abused; and 4) assure them that abuse is never their fault (Godenzi, 2001). Educating minors about the emotional and mental dangers of not reporting experienced abuse may also help in combating this problem.

Known Lifelong Struggles of Adult Victims Below is a short list of 6 examples of known lifelong struggles, experienced by adult victims of childhood sexual abuse, whom never reported their victimization to anyone. 1. Alcohol 2. Drugs 3. Self-harm 4. Shame 5. Anger 6. Low Self-Esteem

Figure 1-A (Conte)

Similarly, the general public often remains uneducated in regards of identifying and reporting the sexual abuse of children. Unfortunately, in comparison to physical abuse, sexual abuse is very hard to detect.. Though rare, there are however known physical symptoms that include constant vaginal and anal bleeding, difficulty walking or sitting, and contracted venereal disease. More commonly children will exhibit behavioral signs such as sexual acting out with other children, exhibiting fear of a certain person, or wearing many layers of clothing despite warm or humid weather (see Figure 1-B).

Signs & Symptoms of Child Sexual Abuse

Disclosure by child (very rare). Physical evidence (very rare). Venereal disease Difficulty walking or sitting. Bleeding in vagina or anus. Depression, crying over insignificant matters. Fear of bathroom. Fear of a certain person. Excessive crying. Wearing many layers of clothing. Sexual acting out with other children. Bedwetting & soiling (after potty training). Nightmares. Abrupt change in behavior, uncharacteristic anger isolation or withdrawal Age inappropriate knowledge of sex. Constantly talks about sex. Constant vaginal discharge. Excessive masturbation. Exhibiting violent behavior.

Figure 1-B ( Newton )

While a few symptoms are generally not cause for alarm, if a child begins to show several of these signs and symptoms there may be reason for further investigation. However, even with reasonable suspicion, some adults fear that a suspected abuser may find out that they made the report, or they may fear other unforeseen consequences. It is for this reason that the option to report suspected abuse anonymously has been made available in the United States. Today, anyone who has reason to believe that a child may be a victim of sexual abuse can call the Childhelp National Child Abuse Hotline at 1-800-4-A-CHILD in order to receive help in reporting suspected abuse (See Figure 1-C). 

The Childhelp National Child Abuse Hotline has received more than 2 million calls since it began in 1982. These calls come from concerned individuals who suspect that child abuse may be occurring, as well as from children at risk for abuse and distressed parents seeking crisis intervention. Serving the United States, it’s territories, and Canada, the Hotline is staffed 24 hours a day, 7 days a week with professional crisis counselors who, through interpreters, can provide assistance in 140 languages. All calls are anonymous and confidential (Childhelp USA). 

CHILDHELP NATIONAL CHILD ABUSE HOTLINE

The Childhelp National Child Abuse Hotline 1-800-4-A-CHILD is dedicated to the prevention of child abuse. Help in Reporting Abuse The professional Hotline counselor utilizes a database of thousands of emergency, social service and support resources. Using your zip code, he or she can look up the local telephone number to report abuse in your area. The Hotline counselor can also suggest what to do next if you have already made an abuse report and the child is still in danger. When you call, the hotline counselor may ask you if you want to report the abuse to the people who can check into what is happening. They can give you the phone number for the reporting agency—usually child protective services—in your community. Counselors can also stay on the phone line and make a 3-way call if you are nervous about doing it alone.

Figure 1-C, Childhelp USA

Lastly, the the average American citizen too often views child sexual abuse as being very rare, and it is easy to stereotype perpetrators as being "creepy men" who spend their time visibly staring at small children in playgrounds. These misconceptions contribute to the amount of cases of child sexual abuse that continually go unreported through out the U.S. each year. The public, understandably, doesn't want to believe that perpetrators could ever be someone they know, love, or trust. However, a child is still most likely to be sexually abused by a family member, or someone they know, increasing the likelihood of delayed disclosure and possible memory failure (Conte). Child sexual abuse is not rare or discriminantive. In the face of this denial, the fact remains that child sexual abuse appears to be equally common across all socioeconomic classes, races, and ethnic groups (McCaghy, 2006). A 1996 report from the Department of Justice estimated rape and sexual abuse of children to cost $1.5 billion in medical expenses and $23 billion total each year to U.S. victims (Miller). It is hard to fathom that a problem which is reportedly so economically draining to it's victims could still be labeled as rare.

CONCLUSION

In closing, the impact of child sexual abuse upon America clearly doesn't stop once the act of the abuse does. There is now an established body of knowledge linking a history of child sexual abuse with higher rates in adult life of depressive symptoms, anxiety symptoms, substance abuse disorders, eating disorders and post-traumatic stress disorder (Mullen). If the misconstrued belief among abused children, in that they are alone, changes then their suffering might not be so easily clouded in secrecy. The early prevention programs mentioned earlier do seem to increase the liklihood that children will report abuse, reduce their tendency to blame themselves for it, and increase their feelings of efficacy (Finkelhore, D. et al.). Childhelp USA has announced one such prevention program, Good-Touch/Bad Touch (GTBT), a nation-wide, research-based curriculum for children in Pre-K through 6th grades. On-going revisions keep this prevention program up to date and relevant and, so far, GTBD has published research in Behavior Therapy, which has validated it as effective prevention by researchers. To date, this research has been replicated twice with the same positive results (Childhelp USA). The greater a child's understanding is in that that they must always tell a trusted adult, no matter who their abuser may be, then the lesser the chances are that so many perpetrators will go unpunished. Furthermore, the greater the public understanding of the societal consequences that child sexual abuse equally imposes, the greater motivation will be to identify and report it to the proper authorities. In the end, with enough knowledge, understanding, and awareness this war against silence can be won.

Work Cited

Butler, S. Conspiracy of silence: The trauma of incest. San Francisco: New Glide Publications, 1978.

Childhelp USA, Prevention of Abuse. March 5, 2007 <http://www.childhelp.org>.

Conte, Ph.D., Jon R. “ Child Sexual Abuse: Awareness and Backlash” The Future of Children Vol. 4 • No. 2 – Summer/Fall 1994

Freyd, J.J., Putnam, F.W., Lyon, T.D., Becker-Blease, K. A., Cheit, R.E., Siegel, N.B., &  Pezdek, K. (2005). The science of child sexual abuse. Science, pg 501.

Hill, J. (2003). Childhood trauma and depression. Current Opinions in Psychiatry., 16(1), 3 - 6

McCaghy, C. H. Capron, T. A., Jamieson, J. D. & Carey, S. H. (2006). Deviant Behavior: Crime, conflict, and interest groups. (7th Ed.). New York: Pearson/Allyn & Bacon

Miller, T. R., Cohen, M.A., B.Wiersema. Victim Costs and Consequences: A New Look (U.S. Department of Justice, Washington, DC, 1996).

Mullen, Paul E., and Fleming, Jillian. “ Long-term Effects of Child Sexual Abuse”. Child Abuse Prevention. Issue 9, Autumn 1998

Newton, C. J. MA. "Child Abuse: An Overview" Counseling & Mental Health Journal (April, 2001).

Rush, F. The best kept secret: Sexual abuse of children. Englewood Cliffs, NJ: Prentice-Hall, 1980

Remember Me: a Poem by Kristin Kathaleen

Remember Me

you awkward monster

you fumbling devil

Remember Me

Remember Me

in your impotence

Remember Me

through tormenting dreams

Remember Me

in the silences between the changing of the moments

Remember Me

like a wild bird that pecks at your brain

Remember Me

when you see that the marigolds are in bloom

Remember me

when the horizontal rain attacks your rooftop and raps at your windowpane

Remember Me

when a pleading sun cries out against morning.

Remember Me

Remember Me

as Women and Men raise their voices and speak out

Remember Me

as they stand up

Remember Me

as they rise

Remember Me

you miserable monster

And above all else:

Remember

that I have forgotten you.

Internet Dangers: Two Girls Tell Their Stories...

ONLINE Safety

 ^{Extra Special Thanks to Katherine Pratt for the Information Below}

Hear the true story of a 15-year-old girl who left home to meet in person with a man she first "met" online. Read "Amy's Story" — the story from her mother's perspective below.

Amy's Choice:  Click Here to View Amy's Story in Her Own Words

AMY'S STORY

from her mother's perspective
by Anne Collier

Fifteen-year-old Amy had been hounding her mother to sign up for internet service at home. �I kind of had a fear of it,� said her mother Sara."Id come home with newspaper articles I'd read about kids being lured by adults they'd met online." But Amy was already using the internet at the public library and school anyway. "She set up her own...account [with a password and free e-mail]."

Sara found out that Amy had been sharing many personal conversations with Bill, whom she had "met" in an online chat room. They discussed her desire to live her life differently. Bill was "sympathetic" to Amy's dreams and desires. By getting to know and sympathizing with her concerns or fears, Bill was able to break down her inhibitions.

When Amy didn't come home one night, Sara knew something was wrong. So she began a search of Amy's room. "I found a note [Amy] wrote saying she was 98 percent sure she was going to do this [trip]. The note said she'd be getting on a bus." At this same time, Amy was at the bus station on the telephone with Bill. He was saying, "You can't go home now, because I'll get caught." Amy felt compelled to keep him from getting apprehended.

Sara said, 'I went to my local police station and tried to get them to go and get her. At that point they really didn't want to do anything. They were thinking she had run away. [We had] the [man's] real name and address...though at that time I wasn't sure it was the real name. I couldn't get anyone to go and see if this was a legitimate address. I found out that in our state runaways don't have to return home if they don't want to.'

Sara called the National Center for Missing & Exploited Children (NCMEC). Sara said it was that call that got the police to check out the address on the ticket and find out whether "...this person actually existed."

A detective had called to say the man's address was a computer dating service. "It turned out this is where that man worked, and he lived upstairs", Sara said. The police said they'd watch the location.

About midnight an officer called in and said, "A taxi just pulled up, a guy and a girl got out of it, we think it's them." He said, "We need to find out [from Amy] if she wants to stay. In order to get her [without her consent], we'd have to get a court order showing the reason why we wanted her out." Sara had to talk to Amy on the telephone and promise not to press charges before Amy would agree to go home.

"We had a 36-hour bus ride back [home].... At first she was really upset. She definitely wanted to be with this man. He'd been telling her, "I'm in love with you, you're the only one I've ever done this with, you just have to come with me and when I put you up i's going to be great." We learned a lot. I learned a lot. I thought I knew a lot about my child."

But something told Sara the ordeal wasn't over. She said, "Three weeks later this man came to our home. [Amy] slipped out...with him. He had continued to contact her, and it wasn't until this meeting that the man assaulted [Amy], in a motel in our own town."

NCMEC contacted the police department who sent a detective to intercept Amy and Bill before they boarded a bus. It wasn't until police approached them in the bus station that Bill told Amy she was not the first girl he'd contacted on the internet and lured into meeting him in person. This was the turning point for Amy, what she'd needed to hear. Not until then could she tell her mother, "I can't believe I got suckered into this." Bill was convicted and sentenced to a year-and-a-day term in federal prison. Bill was released in April 2001 to the United States Probation Office where he was placed on probation for three years.  Sara told us they still get calls with no one at the other end of the line.

We asked Marsha Gilmer-Tullis, who is the NCMEC family services advocate and familiar with Amy's case, why she thought Amy succumbed to this predator "the death of a close step-grandfather, feeling sorry for Bill, adventure-seeking, fears about the new millennium" Marsha said, "All of the above. There are lots of issues, usually. Being a teenager is a very difficult time, and there are issues and concerns that teens are struggling with. It's often so much easier to get online, where you're anonymous and the other person is anonymous, and talk. You're feeling dejected and unattractive, and someone's telling you how wonderful and beautiful you are. They're a teen and immature, and the adult knows that and takes advantage of it."

It's still difficult for Sara to tell this story. She's doing so, "To keep other families from going through what we went through. [Amy]'s feeling is the same as ours. She wants to help other kids. [Predators] catch [teenagers] at their weakest moment, and they prey on that."

We asked Sara what advice she�d give other parents of online kids. "Know who your kids are with. I would say, watch them when they're online, but you can't always do that. Don't give out any addresses, don't agree to meet anyone, don't believe everything you hear and see - they may be telling you that they're 15, 14, or 12, but they're actually probably 30, 40, or 50 years old.... Don't think that they can't come to your house, because they can! Listen to your feelings. Make sure you know where else your child might be using a computer; at a friend's house, library, or school."


UPDATE: In December 2004, Bill was arrested again and sentenced to ten years in federal prison for kidnapping a 15-year-old girl he met on the internet.

http://www.netsmartz.org/resources/reallife.htm

THE TRUE STORY OF MY INTERNET PREDATOR

 by Katherine Pratt, Internet Safety Educator

Once upon a time, I had a great group of friends. They made me laugh, and made me feel loved and accepted. I was 16 and in my Junior year of high school.

Unfortunately in other parts of my life, I was very unhappy. I never talked to my friends about it, because I wanted to enjoy the time I spent with them, not spend it wallowing in self pity.

During the summer I couldn't hang out with them much, and life at home was very stressful. Going through puberty is tough enough, but I found a way to cope, THE INTERNET. (DUN DUN DUN) *thats supposed to be doomy music.

On a local chat room, from a friends computer, I met someone I shouldn't have. This person never revealed his age although he knew mine. He focused on me so devotedly that I was extremely flattered. No one taught me to be cautious.

I feel very stupid, because this person was poisoning me against my family, and using flattery and very convincing reasoning to draw me away from them. I hate to admit it, but I was completely fooled. He made me feel so smart and pretty, and he was such a smooth talker.

He never revealed his age until he was sure I was not going to run. He tricked me into falling for him before we ever met, and he was good at it because he had so much more experience than me.

I started meeting with him in secret. We could only meet at night, so I would sneak out and most of the time, not come back until morning.

I was suffering from some pretty serious sleep deprivation on a daily basis, and my home life was extremely stressful on top of it. I fought with my parents and siblings all the time. My grades were suffering. I even started thinking my dreams actually happened. I was one seriously confused and messed up kid.

When I decided to run away with him I had just had a major blow to my self esteem. As trite as it may seem, I didnt get the lead in the school play, and that wouldnt have set me over the edge if the girl that did get it wasnt the same girl that got every damn lead, in every damn play. When I heard she got the lead it was official that the world was completely unfair.

Teenagers... Now of course that seems completely unimportant.

So in a sleep deprived moment I made a fateful move that was so drastic I couldnt take it back. I ran away from home with the man I met on the internet, who was 49 years old. There would be no returning to high school with after that. So I pretended it was a good choice, and I had myself convinced for 3 years.

my friends...
I couldnt imagine facing any of you again after what I did. I was in so deep that I was convinced you would all hate me, or pity me, or think I was messed up. You would have been right of course.

I actually convinced myself that I was happy, and I was better with him. When reality hit that he was insane and a mind washing child molester, the shame only got worse.

When I left him he turned on my family, confronting them in public places and telling them outrageous lies about me. He had half the people at my workplace convinced that I had died of a brain tumor. He stalked me, showing up inside my car in the dark, and left long horrible suicide messages on my answering machine. He sent anonymous emails to my mother, pretending to be someone else, and threatening to kill me.

I eventually left the state to get away from him, staying away for years just to avoid him. He continued to torment my family in my absence, and I brought it on them.

Over the last 6 years I have started to find myself and what is important in life. I am very lucky that something really horrible didnt happen. I have a beautiful family, and I am currently working for a company that teaches women safety and awareness to keep from becoming a victim. I am the president and moderator of the internet division of that company. I teach women how to be safe on the internet, not give out personal information, not meet someone in person they met online alone, that kind of thing.

I want to apologize to all the people I hurt, or scared when I went away. Some of them I know will never forgive me. I wish I could take back what I did. Maybe, just maybe I can keep some young person from making the same mistake.

I want to send this message and help people understand. I was a smart kid, I was just young! PLEASE never meet anyone you first met online alone. DO NOT keep internet friendships to yourself, even if you just share the details with a friend, it could protect you, or even save your life.

I threw away 3 years of my life. I put my family through tons of heartache. and you know what, It could have been a lot lot worse.

One of the Lucky ones,

Katherine

 

For More Information, Visit Katherine at:

www.myspace.com/wseg

 

 

 

FURTHER INFORMATION & RESOURCES:

 

WWW.SAFESURFINUSA.ORG

 

 www.TEENANGELS.org

 

 www.myspace.com/wseg

 

 www.wseg.org

 

 www.netsmartz.org

 

NAMI ALERT:

With the shape of our economy currently, we can't afford anymore cuts for funding.  Please visit the links below and contact your state representatives!  We've got to fight this!

- Joanna 

Help Restore Cuts to Mental Illness Research, Housing, and Veterans Programs November 14, 2006 Even though the 2006 elections are now over, the 2006 congressional session is not and House and Senate members returned to Washington this week to complete unfinished business for this year, including current fiscal year funding bills covering a broad range of domestic programs including mental illness research and services, housing and veterans’ programs. At stake is funding for current fiscal year priorities at a range of agencies including NIMH, SAMHSA, the VA and HUD. This includes efforts to restore cuts originally put forward by the President, and in some cases, to maintain increases endorsed by the Senate. Critical to this effort is restoring the overall $5.5 billion difference in overall spending authority between the Senate and the House. Learn more about the cuts to mental illness research, housing and veterans programs. Action Requested NAMI therefore urges advocates to contact their members of Congress and encourage their support for restoring the $5.5 billion in spending authority recommended by the Senate for FY 2007.  NAMI is especially grateful to Senators Arlen Specter (R-PA), Tom Harkin (D-IA) and the Representative Mike castle (R-DE) that have led efforts in the Senate and House to achieve this important goal. Click here to send a letter to your Representative today!

Dissociative Identity Disorder: Real or Imagined?

Dissociative Identity Disorder:  Hoax or a Reality?

By:  Joanna M. Doane 

        Dissociation is the disconnection from full awareness of self, time, and/or external circumstances.  Researchers and clinicians believe that dissociation is a common, naturally occurring defense against childhood trauma.  It is a complex neuropsychological process, and exists along a continuum - from normal everyday experiences, to disorders that interfere with everyday functioning.  The most common examples of normal dissociation are highway hypnosis (a trance-like feeling that develops as the miles go by), "getting lost" in a book or a movie so that one loses a sense of passing time and surroundings, and daydreaming (USC:  Counseling and Human Development Center).  While there are common forms of dissociation such as these, dissociation can also progress into actual disorders.  One such disorder has come to be known as dissociative identity disorder (abbreviated as DID).  

        According to the Diagnostic and Statistical Manual of Mental Disorders (4th Edition, Revised), in order for the diagnosis of DID to be made, an individual must exhibit the symptoms of  having at least two different personality states that co-exist within them.  These states must continuously take over the individual's behavior -  with each exhibiting unique patterns of  understanding and communicating.  In theory, dissociative identity disorder develops as a result of chronic dissociation, used by children who dissociate as a defense mechanism in response to physical or sexual abuse.  Over time, however, for a child who has been repeatedly abused, defensive dissociation becomes reinforced and conditioned.  Repeated dissociation may result in a series of separate entities, or mental states, which may eventually take on identities of their own. These entities are essentially made up of chunks of the child's subconscious, weaving in and out of control as the daily abuse continues.   

        However, many professionals in the field of psychology don't believe that dissociative identity disorder is a valid diagnosis, but that it is dreamed up by therapists who want their patients to have DID.  The disorder was once thought to be so rare that Professor's in Universities across the country didn't bother covering it in their courses because they assumed their students would never encounter it during their careers.  Then,  in the early 90's things began to change and suddenly there was a sharp increase in diagnoses being made.  This sharp increase over such a short amount of time has greatly contributed to why so many in the psychiatric community consider this development to be nothing more than a hoax (Hockenbury).  For instance, Deborah Haddock, author of "The Dissociative Identity Sourcebook", believes that  DID affects up to 1% of the population. This would make the cases of DID equivalent to the percentage of people who are afflicted with schizophrenia.  This is a huge jump from the proposed extremely rare and unheard of disorder that DID was once thought to be.  But is it enough to support the theory that the diagnoses isn't just rare, but that it is entirely faked by every patient diagnosed?    

        In an article written by Dr. Paul R. McHugh, the doctor states his belief that the symptoms of DID are comparable to symptoms of hysterical seizures that were recorded in one case study from the early 1800s.  In these case studies patients were found to be copying behavior that they'd seen in true epilepsy patients in response to the attention from their doctor who thought he'd discovered a new "hysterical epilepsy" disorder.  To  illustrate his point, Hughs goes on to quote an introduction to multiple personality disorder, written by the director of the Dissociative Disorders Treatment program at a hospital in North Carolina.  The director, Stephen E. Buie, MD, wrote the following instructions for therapists to follow, in order to find personalities in their own patients:
 
        “It may happen that an alter personality will reveal itself to you during this [assessment] process, but more likely it will not. So you may have to elicit an alter... You can begin by indirect [sic] questioning such as, ‘Have you ever felt like another part of you does things that you can’t control?’ If she gives positive or ambiguous responses ask for specific examples. You are trying to develop a picture of what the alter personality is like...At this point you may ask the host personality, “Does this set of feelings have a name?”...Often the host [primary] personality will not know. You can then focus upon a particular event or set of behaviors. ‘Can I talk to the part of you that is taking those long drives in the country?’”       
     
        Its easy to see, by this example, how Hugh's could come to the conclusion that DID is a created disorder. However, despite this hoax theory, I am in agreement with the more recent studies.   These studies have shown that the actual keys to this increase in diagnosis's lays in the enhanced awareness of childhood mistreatment and its consequences, improved diagnostic methods, and the increased awareness of the condition as a whole.

        According to Joan A. Turkus, M.D., from the UK Society for the Study of Dissociation, as society has become increasingly aware of the prevalence of child abuse and its serious consequences, there has, likewise, been an explosion of information on dissociative disorders. As an example, we'll look at the diagnosis of depression.  With the increased understanding of the biochemical changes in the brain that lead to depression, it has become the most common form of mental illness reported in the United States.  Over the past several decades it now has been found to affect millions of American’s each year.  With this in mind, as knowledge of childhood abuse, and its widespread affect on society has significantly increased since the early 90's, the likewise increase in the diagnosis of dissociative identity disorder becomes more understandable.   Since most clinicians learned little about childhood trauma and its after effects in their training, many are struggling to build their knowledge base and clinical skills to effectively treat survivors of childhood abuse (Turkus).  

        According to Michael D. DeBellis M.D., developments in the field of Developmental Traumatology have been key to understanding the phenomena of dissociation and, in turn, the nature of DID.  DeBellis states that Developmental Traumatology is the scientific study of the mental and psychobiological impact of overwhelming and chronic interpersonal violence on the developing child.  Research in the field has indicated that traumatic and normal memories can coexist as parallel sets without ever being mentally combined. In extreme cases of dissociation, such as with DID, different sets of dissociated memories have been known to alter into the sub personalities of dissociative patients.   The greatest evidence for the legitimacy dissociative identity disorder has been found in brain imagery studies of subjects that has actually recorded and shown the physical transference between their personality states.  Furthermore, according to the American Association of Psychiatry, alter personalities can have differences in prescriptions in eye glasses, different allergies, changes in pain tolerance, and even different levels of blood glucose than that of the primary personality.  

        Despite these examples, problems in recognizing the disorder in patients still exist.  Lack of knowledge and information may lead to misdiagnoses of dissociation, particularly when people are describing symptoms that are common to other mental health problems, such as depression. Because so many mental health professionals have received insufficient training on dissociative disorders, they may not ask the right questions during patient assessments. Current statistics show that the average patient with DID will spend up to an average of 7 years in the mental health system before being correctly diagnosed with dissociative identity disorder (Haddock, 2001).  In the UK, professionals often use the ICD10 diagnostic manual. But this manual does not distinguish the disorder as clearly as the Diagnostic and Statistical Manual of Mental Disorders (4th Edition, Revised), which is standard in the United States.  The ICD10 uses the out-dated term of multiple personality disorder which DID was known as until 1994.  The ICD10 also gives little detail about how to recognize the condition, states that multiple personality disorder is rare, and is skeptical about it's causes.  On the other hand, the very nature of the dissociation can make it significantly difficult to detect.  For instance, it is standard to ask about any past childhood trauma during patient assessments, but if the abuse suffered during an individuals childhood has been buried outside of their conscious awareness, then the patient may deny any trauma in their past history, due to dissociative amnesia. 

        One of the biggest breakthroughs in the study of dissociation came with the development of The Dissociative Experiences Scale.  The scale, developed by Eve Bernstein Carlson, PhD. and Frank W. Putnam, M.D., is derived from extensive clinical experience with an understanding of DID. In the initial studies during its development and in all subsequent studies, the DES has discriminated the diagnosis of DID from other diagnostic groups at high levels of significance.  The higher a patients DES score, the more likely it is that they have dissociative identity disorder.  The DES is the only dissociative instrument that has been subjected to a number of replication studies by independent investigators.  Because of its extensive research base, it is the best self-report instrument for measuring dissociation available.  To date, the DES has been translated into nineteen languages other than English.  Furthermore, cases of dissociative identity disorder have been found outside the United States.  So far, to date, prevalence studies have universally found the presence of DID, with symptom expression very similar in each case (Steele).  Prevalence studies have been conducted in countries that include Australia, Czech Republic, Germany, Hungary, India, Japan, Netherlands, New Zealand, Norway, Scotland, Sweden, and Turkey.

        In conclusion, as rare as it may be, to say that DID is entirely non-existent is quite a stretch.  It is all too understandable that a specific diagnosis is harder to make for a rare disorder that is still so misunderstood. While there is room for error, to say that dissociative identity disorder is nothing more than an invention of doctors who are trying to take advantage of their clients just doesn’t add up.  With the biological evidence provided by Dr. DeBellis, it is hard to deny the reality of dissociation, including the diagnosis of DID.  Especially when taking into account the physical proof of brain imagery studies, and the increasing data that supports the existence of dissociative disorders.   In closing, while DID may be overly diagnosed, and perhaps even being created by some professionals, I believe it is still a genuine disorder that exists in a small percentage of individuals.  With the increased awareness of child mistreatment and its affect on a child’s psyche, as well as with the improvement in methods in properly diagnosing dissociation, it is hard to fathom that the entire diagnosis is nothing more than a sham.  In the end, for the small percentage of patients that do suffer from this disorder, to deny their suffering and scoff at their symptoms only causes an elevation in their sense of alienation.  In this, I speak of the alienation that comes with being a part of any minority, especially one compacted by the stigma that already surrounds mental illness in itself.  In the end, it simply just does them a huge disservice.      

Works Cited

Allison, Ralph B. M.D., Minds in Many Pieces: Revealing the Spiritual Side of Multiple Personality Disorder. Paso Robles: CIE Publishing Inc., 1999.

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