Dissocial personality disorder

The involvement in Project Monarch was not simply sexual. According to O Brien, the MPD would trigger a Dissociative Identity Disorder or DID. Mind control experts knew this could lead to an extraordinary high pain threshold, a heightened visual acuity and a compartmentalization of her memory which would allow for retention of detailed messages and data that she would not ordinarily comprehend. These memory compartments are what clinicians would refer to as personalities. This would allow O Brien and others like her to perform a variety of sexual and diplomatic tasks for the puppet masters in the CIA, DIA, NS A, or any of the other security agencies in the alphabet soup of government security acronyms. 

Carlson, E. B., Putnam, F. W., Ross, C. A., Torem, M., Coons, P., Dill, D., et al. (1993). Validity of the Dissociative Experiences Scale in screening for multiple personality disorder A multi-center study. American journal of Psychiatry, 150, 1030-1036. 

Dissociative identity Disorder (DID). There are numerous similarities between this dissociative illness, which includes multiple personality disorder, and BPD. Patients with both disorders are commonly victims of physical or sexual abuse as children and experience intense shifts in affect and periods of dissociation. Some clinicians in fact discount the validity of DID as a psychiatric diagnosis, contending that the phenomena of DID can be explained by BPD. In fact, severely ill BPD patients very much resemble the prototypical patient with DID. 

The book concludes with Chapter 13 and Chapter 14 on disorders that require separate consideration. The first group includes Panic, Obsessive-Compulsive, Post-Traumatic Stress, Somatoform, and Dissociative disorders. Although traditionally these are classified as anxiety disorders, their symptoms and varied treatment responsivity require a separate series of discussions. Finally, certain groups of patients are considered in light of their specialized needs when contemplating psychotropic drug therapy. They include the pregnant patient, children and adolescents, the elderly, the personality disordered, as well as patients whose conditions are complicated by medical problems (e.g., the alcoholic patient the HIV-infected patient). 

Psychotherapy, with emphasis on the strength of the therapeutic alliance, has been used more often than drugs for such patients, with hypnotherapy specifically used as an intervention for multiple personality (dissociative identity) disorder ( 303, 304). In The Netherlands, individual psychotherapy and adjunctive anxiolytic or antidepressant medications are the most widely endorsed treatment modalities (305). 

E. The symptoms do not occur exclusively during the course of a pervasive development disorder, schizophrenia, or another psychotic disorder and are not better accounted for by another mental disorder (such as a mood, anxiety, dissociative, or personality disorder). 

ADHD should not be diagnosed if the symptoms can be better accounted for by other mental disorders, such as mood disorder, Tourette s syndrome, anxiety disorder, dissociative disorder, personality disorder, personality change due to a general medical condition, or a substance-related disorder (e.g., due to bronchodilators, isoniazid, akathisia from neuroleptics). Moreover, ADHD is not diagnosed when symptoms occur exclusively during the course of a pervasive developmental disorder or psychotic disorder (American Psychiatric Association, 2000). Conditions other than ADHD, such as neurofibromatosis, fetal alcohol syndrome and lead poisoning, of which ADHD features are typical symptoms (Pearl et al., 2001), should also be ruled out. 

The observation that certain regressive forms of psychotherapy may contribute to the emergence of personalities lends some credence to this argument. Some argue that DID is an iatrogenic ally created when the shifting mood states of a borderline patient are assigned personalities. This issue obviously needs further research, and its resolution is beyond the scope of our discussion. However, it reminds us that those with severe dissociative disorders should carefully be screened for BPD. 

Because of the chronicity of illness, persons with GAD and panic disorder are at high risk of developing benzodiazepine dependence. Benzodiazepine dependence is a physiologic phenomenon demonstrated by the appearance of apredictable abstinence syndrome (withdrawal symptoms) on abrupt discontinuation of therapy. Withdrawal symptoms may result because of the sudden dissociation of a benzodiazepine from its receptor site. After abrupt discontinuation, an acute decrease in GABA neurotransmission results, producing a less inhibited CNS. 

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