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Child Abuse And Multiple Personality Disorder

Philip M. Coons, M.D.
Department of Psychiatry, Indiana University School of Medicine

Abstract: The syndrome of multiple personality is associated with a high incidence of physical and/or sexual abuse in childhood. Occasionally those with multiple personality abuse their own children. Multiple personality is difficult to diagnose both because of the nature of the syndrome and because of professional reluctance. Although multiple personality is most difficult to diagnose during childhood because of the subtlety of the syndrome. The much higher morbidity found in adult cases makes it imperative that it be diagnosed and treated early in order to avoid further abuse and greater morbidity and to shorten treatment time. This review describes the history, clinical features and treatment of multiple personality, particularly in children, in addition to exploring the professional reluctance to make the diagnosis.

Introduction: MULTIPLE PERSONALITY DISORDER is of special interest to clinicians interested in child abuse and neglect because patients with multiple personality were almost invariably abused either physically or sexually when they were children. Like other victims of child abuse. sometimes those with multiple personality abuse their children. Also. like child abuse. there is a professional reluctance to diagnose multiple personality. Perhaps most importantly, clinicians working in the area of child abuse have the opportunity of diagnosing incipient multiple personality in children and initiate early intervention leading to successful treatment.

History Of Multiple Personality

The history of the dissociative disorders, which include multiple personality, extends back into the New Testament times of the first century when numerous references to demon possession, a forerunner of multiple personality, were described [1, 2]. The phenomenon of possession continued to be prevalent until well into the 19th century and is still prevalent in certain areas of the world [2, 3]. However, beginning in the 18th century, the possession phenomenon began to decline and the first case of multiple was described by Eberhardt Gmelin in 1791 [2]. The first American case, that of Mary Reynolds, was first reported in 1815 [2]. The late 19th century saw a flurry of publications about multiple personality [4], but the relationship of multiple personality to child abuse was not generally recognized until the publication of Sybil in 1973 [5]. The growth of interest in multiple personality has paralleled that of incest with which it is closely related. The reports of both incest and multiple personality have greatly increased since 1970 [6].

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