Dissociative Identity Disorder: A Better Understanding

Dr. K K Leung
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Dissociative identity disorder, previously known as multiple personality disorder, is a complex psychological condition that may develop after trauma during childhood. The public often misunderstands the experience, origins or even the treatments of this disorder. As stated in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the 12-month prevalence of dissociative identity disorder among adults in a United States community study was 1.5%. The disadvantaged group shall be recognized and destigmatized through public education about dissociative identity disorder. 


Learn more about the symptoms, causes and treatments of dissociative identity disorder and understand how to manage the condition in Hong Kong.

What is Dissociative Identity Disorder?

The development of dissociative identity disorder is usually associated with overwhelming traumatic experiences or abuses during childhood. Dissociation, a major mental process in dissociative identity disorder, may occur at any age (from early childhood to late life) after exposure to traumatic events. During dissociation, people undergo a mental process that involves a disconnection and a lack of continuity between thoughts, memories, feelings, actions or even a sense of identity (usually not present in childhood). Assumably as a coping mechanism, dissociation shuts off their conscious selves from traumatic memories or experiences.

Signs & Symptoms of Dissociative Identity Disorder

The core feature of dissociative identity disorder is the division of identity. An individual with dissociative identity disorder will have 2 or more distinct identities, with the core identity being the usual personality. People with the disorder may have up to 100 “alters” with different genders, ethnicities and ways of living. The “alters” may be imaginary people or even animals. Switching, in which a different personality emerges and takes the place of the dominant one, may take seconds, hours to days. People may also experience recurrent episodes of amnesia, a deficit in memory of important personal information which cannot be explained by ordinary forgetfulness. 


Apart from the 2 features mentioned, individuals with dissociative identity disorder usually experience a number of the following symptoms as well:

  1. Recurring, unexplainable intrusions of their conscious functioning and the sense of self, such as voices and intrusive thoughts, emotions and impulses.
  2. Changes in the sense of self, including attitudes and feeling a loss of ownership over one’s body.
  3. Odd perception alterations, involving depersonalization or derealization.
  4. Functional neurological symptoms that come and go.
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Risk Factors and Causes of Dissociative Identity Disorder

As revealed by a 2016 study, dissociative identity disorder is most likely the consequence of a psychological response to environmental and interpersonal stresses, especially during early childhood, when emotional neglect or abuse can gravely disrupt personality development. During a critical developmental stage of childhood (usually before age 6), many people who acquire the disorder have personal histories of persistent, overwhelming and even life-threatening disturbances or traumas. Apart from overt physical or sexual abuse, dissociations may also result from ongoing negligence or emotional abuse.

Diagnosis of Dissociative Identity Disorder

There is not any single test that can diagnose dissociative identity disorder. The symptoms or personal health history will be considered together with some physical tests to make a diagnosis. 


Symptoms of dissociative identity disorder often appear in early childhood, but can be easily missed by parents, teachers or healthcare providers, who may confuse the disorder with other behavioral or learning problems, delaying its diagnosis until adulthood. The average time needed for accurate diagnosis is estimated to be 7 years due to its similarity with other diagnoses. The comorbidity of dissociative identity disorder with personality disorders, depression and anxiety coheres with the difficulty in accurate diagnosis.


There are mainly 5 criteria in diagnosing dissociative identity disorder:

  1. The disruption of 2 or more distinct personality states, involving marked discontinuity in the sense of self and sense of control.
  2. Recurring existence of gaps in the recall of everyday events, important personal information, or traumatic events (different from ordinary forgetfulness).
  3. The individual is significantly distressed by the symptoms, or may have impaired functioning in social, occupational or other major life areas.
  4. The distress is not a normal part of any ordinary religious or cultural practice.
  5. The symptoms cannot be explained by the physiological effects of a substance or any other general medical conditions.


There are currently no evidence-based treatments or cures for dissociative personality disorder. Many treatments are delivered only specific to case reports of diagnosed individuals. Below are some existing treatments:

  1. Psychotherapy: The therapy is designed to empower individuals to gain insights into what triggered or triggers their dissociative identity disorder. It aims to help combine the existing personality states into one consolidated personality trait that can have agency over the triggers. The involvement of family members is usually essential.
  2. Hypnotherapy: Clinical hypnosis can be applied to access repressed memories and control behaviors accompanying dissociative identity disorder. Together with psychotherapy, hypnotherapy can help merge the personalities into a stable one.
  3. Adjunctive therapy: Assisting therapies such as art or movement therapy can aid individuals in connecting with parts of their mind that they have shut off as a coping mechanism.

Do you need help?

If you are looking for professional advice, you may reach out to the services below: 


Hong Kong Association Concerning Dissociative Disorders (HKACDD) 

Facebook: ReU Trauma Recovery Network 

Instagram: reunetwork 

Email: [email protected]  


If you are in need of immediate support, please do not hesitate to reach out for professional help. Below is a list of hotlines with 24-hour support: 


The Samaritans 

Hotline: 2896 0000 

Available languages: English, Cantonese, Mandarin 


Suicide Prevention 

Hotline: 2382 0000 

Available language: Cantonese  


The Samaritan Befrienders Hong Kong 

Hotline: 2389 2222 

Available language: Cantonese


What is the difference between dissociative identity disorder and multiple personality disorder?

Dissociative identity disorder was previously known as multiple personality disorder. It is a complex psychological condition that may develop after trauma during childhood. There is no difference in their characteristics.

Can a person with dissociative identity disorder live a normal life?
What is the main personality in dissociative identity disorder?
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This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.

Dr. K K Leung
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