Dissociative Identity Disorder and Legal Ramifications

Dissociative Identity Disorder and Legal Ramifications Robert Munro Law and Psychology Considering Dissociative Identity Disorder and  Legal Ramifications Dissociative identity disorder (DID) formerly known, as multiple personality disorder is a controversial psychopathology involving complex disturbances of the self and memory wherein multiple identities are said to coexist within the same person. The first known case of DID was recorded in the 1600s and experienced a steady spike in prevalence during the 19th century (Farrell, 2011, pp. 402406). The separate identities and periods of profound memory disturbance seen in DID lead to important questions when determining criminal responsibility in court proceedings. Defendants have claimed to commit serious crimes while in a dissociated state and under the guise of an alternate identities (Farrell, 2011, pp. 402-406). DID is typically associated with severe childhood trauma and abuse but its origins are hotly debated bringing into question issues of malingering and false memories (Piper and Merskey, 2004, pp. 592-600). The National Institute of Mental Health (Nimh.nih.gov, 2014) reports that although occurring in only 1.5% of the general population, DID is about as common as bipolar (2.6%) and schizophrenia (1.1%). In popular culture, DID has been depicted in horror films such as â€Å"Identity†, comedy movies like â€Å"Me, Myself Irene† and even the recent children’s film â€Å"The Lego Movie†. It is these factors of low but significant rate of occurrence of DID, amnesiac elements of the pathology, high comorbidity with other disorders and the myths created and portrayed by popular media, that form many challenges to having a critical understanding of DID. In this paper, I will discuss the scientific literature surrounding DID to dispel the myths surrounding the disorder and to provide an accurate account of the disorder. I will look at how DID is handled in court proceedings as a legal defense. Finally, I will argue that the topic of DID although involving a number of non-trivial problems should have a trajectory of further understan ding and a drive to create new policy when dealing with DID in the courtroom setting. In this argument, I call upon the importance of the false memory debate involving the children of abuse and posit that DID has similarly challenging issues and is just as worthy of serious discussion. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes DID as having the defining characteristic of the individual having two or more distinct personality states or an experience of possession (American Psychiatric Association, 2013, pp. 292-298). The average number of personality states reported is 10 but cases have been observed of as few as 2 to as many as 100 distinct personality states (Nami.org, 2014). The degree to which these personality states are evident or hidden varies with the psychological state of the person and the environment in which they operate. Prolonged periods of identity disruption or amnesia may occur when under extreme stress. Individuals that experience non-possession like symptoms on average do not have overtly evident identity disruption. However, individuals that do experience possession like symptoms do typically display overt identities and personality changes. It is important to note that whether the disorder presents with observa ble identity disruption or not, the disorder is still diagnosable through reported discontinuities in the sense of self and sense of agency and recurrent dissociative amnesias. People with DID report experiences of depersonalization where they feel as if they are observing themselves. They also report feelings of being powerless to stop their actions. Similar to Hollywood scripts, some sufferer’s experience changes in the voices of their inner dialogue or multiple bewildering independent conversations taking place in their mind involving these foreign voices. Individuals have also reported changes in preferences, attitudes and the somatic changes as if their body was suddenly a different shape. Observers of these individuals report outward changes to affect and behavior along with sudden breaks in speech as if cut off mid-sentence. Episodes of amnesia and memory disruption are very prevalent in cases of DID and present themselves in three ways according to the DSM. The first is through amnesia of important life events such as periods of childhood or the death of a relative. The second is through difficulties remembering what happened today or how to execute previously learned skills. Lastly, is the confusing discovery by the individual of evidence that points to periods of dissociation and amnesia that occurred at some unknown point in their recent past. This may come in the form of discovering injuries, written texts, or other bits of evidence that come as a surprise to the individual. Dissociated fugues involving dissociated travel are common, resulting in the individuals finding themselves somewhere they do not remember traveling. Awareness of these memory problems varies with the individual. These symptoms are commonly under reported or ignored by the individual from social pressure, lacking awareness or ou t of embarrassment at having a faulty memory. Already, we can see that DID is much more nuanced than popular media would lead us to believe. DID sufferers do not always present with obvious and flashy symptoms found in the movies. They also are likely to not know they are suffering from DID or to hide their symptoms in a bid to â€Å"not look crazy† (Tartakovsky, 2011). They are likely to be in the mental health system for several years before reaching a proper diagnosis. However, there is some overlap between our cultural understanding of DID and science’s understanding of DID. Memory gaps, voices and depersonalization do seem to occur frequently. We clearly have a powerful psychopathology but an insidious one that is hard to develop a treatment history for with memory gaps and variable awareness. This disorder is therefore hard to prove in court. This is only the beginning of the controversy surrounding DID though. The central controversy surrounding DID is how the disorder is caused. One side of the debate believes that DID comes about as a reaction to trauma (Farrell, 2011, pp. 402406). The other claims that DID is produced by improper psychotherapy (Piper and Merskey, 2004, pp. 592-600) and a heightened hypnotic suggestibility found among DID sufferers. Both sides of the debate suffer from a lack of research with the National Institute of Health funding not a single treatment study (Tartakovsky, 2011). Individuals with DID commonly report having experienced extreme abuse in early childhood. When abuse is not reported, other extreme traumas are cited (Simeon, D. 2008). However, these claims of abuse are disputed in much of the same ways that are involved in the false memory debate (Frances, 2000). The hypothesis for a trauma creation model of DID is that the mind of the child experiencing severe trauma may try to shield itself from experiencing said trauma. In this defense mechanism, separate identities with different memories and experiences may result. It is further hypothesized that DID may be a form of post-traumatic stress disorder as it presents itself in children, mixing with a more frequent use of imagination and fantasy as a coping mechanism (Gillig, 2009, p. 24). The suggestibility involved in imagination and fantasy often debated when children are involved is at the heart of the competing cause for DID. As a part of the recovered memories movement, it is hypothesized that DID may be created through improper use of recovered memory techniques. In favor of the argument are claims that dissociative symptoms and memory gaps are seldom reported before in-depth therapy. The theory proposes that malingering and heightened suggestibility (found to be highest in DID followed by PTSD) can combine with attempts at hypnosis to form the role of a DID sufferer. The questions raised are important to consider in a legal context but it should also be noted that the DSM-5 contains information on the nature of malingering most often seen in DID diagnosis. In this respect, popular culture helps to differentiate malingering from actual pathology. Malingering individuals will rarely report subtle symptoms of the disorder and will over report well-known symptoms. This can be seen in an under reporting of comorbid symptoms and sometimes an enjoyment of having the disorder rather than being ashamed as genui ne sufferers often are. Unfortunately, there are reports of stereotyped alternative identities that are â€Å"all-good† or â€Å"all-bad† in a bid to escape punishment for crimes (American Psychiatric Association, 2013, pp. 297). Lastly, the validity of DID diagnosis and its use in the courtroom is challenged on the basis that is it very rarely diagnosed in children (Piper and Merskey, 2004, pp. 678-683 Boysen, 2011, pp. 329-334). Proponents of the therapy-induced DID theory claim that this lack of DID diagnosis in an age range where DID alternate identities are known to occur may point to the diagnosis being a role played result of therapy and not a genuine pathology. The counter to the traumatic model of DID also points out that most research studies on DID rely on self-report of abuses and not on independently verified abuse by outside parties. In addition, outside of case studies, the same four researchers have published the majority of research involving groups. It is these several methodological shortcomings along with the potential for malingering and the dubious nature of proving amnesia beyond the shadow of a doubt that presents significant hurdles to genuine sufferers of DID and as a defense in the court of law. Today, among the field of psychology there is a consensus that that DID is closely related to PTSD and Borderline Personality Disorder and is probably the result of an employed survival strategy with maladaptive results. However, this is a completely different story in the courts. When DID is used as a defense in court it is typically brought up as an affirmative defense of not guilty by reason of insanity (NGRI). The defense is responsible for proving mental illness and meeting the requirements of insanity in that state. The first time DID was recognized as a mental illness that could excuse criminal responsibility was in State v. Milligan in 1978 (Farrell, 2011, pp. 402-406). In this case, it was argued that the defendant was insane and not guilty of several counts of rape because they did not possess an integrated personality. Instead, the defendant was said to have within himself both identities that were criminally responsible and non-responsible. The public was outraged at this successful defense and the multiple personality defense failed notably in the trials that followed (State v. Milligan, State v. Darnall, State v. Grimsley, State v. Kirkland, etc). During this period the conversation raised several important questions on what criminal responsibility entails in a person with multiple personalities and several instances of expert testimony being inadmissible but we now turn to the strategies utilized in DID defense (NGRI) cases. The defense in DID cases usually utilizes one of three tactics in proving insanity with DID (Farrell, 2011, pp. 402-406). The first and most prominent tactic is the idea that one of the other identities was in control at the time that the crime was committed. A second tactic is to try to prove to the jury that a particular personality of the defendant may meet the standards for insanity. Lastly, the defense may attempt to prove that the main personality or dominant identity of the defendant meets the standards for insanity. In other legal proceedings outside of DID, the dissociative state itself is hotly debated and it is not well established whether dissociation alone can provide reason for NGRI. Part of this debate concerns the question of whether personal control is removed during dissociation or if memories are simply not encoded for future retrieval (Kennett and Matthews, 2002, pp. 509-526). DID is unique in this sense in that it involves the idea of agency and personal identity. In the case of DID, an argument can be made for the level of autonomy and self-control being altered during dissociative and amnesiac states. Critics of this position counter that acquittal should rest on whether the criminal behavior is involuntary, regardless of the state of consciousness. However, as evident from case reports and the DSM-5, some suffers of DID do experience a frightening loss of control or being unable to self-direct action while in a depersonalized state. In more recent times, DID evidence has been rej ected in proceedings for failing to meet the requirements of reliability that expert testimony must possess. The controversies discussed earlier and difficulty in reliably diagnosing DID create a significant challenge to satisfying Daubert criteria. In addition to the hurdles of meeting Daubert criteria the court must consider the low base rate of DID prevalence and the high possibility of false positive diagnosis in the face of a malingering defendant. A multidisciplinary and multitechnique approach is taken to carefully diagnose DID but is criticized for relying on self-reported data and being susceptible to malingering. Some of the tools for diagnosing dissociative identity disorder include the ‘Structured Clinical Interview for Dissociative Disorders’ (SCID-D), the ‘Dissociative Disorder Interview Schedule’, the ‘Dissociative Experiences Scale’ and the ‘Childhood Trauma Questionnaire’ (Farrell, 2011, p. 33). Although the SCID-D has been tested comprehensively and has been shown to have excellent reliability and validity, the fact still remains that dissociation alone does not necessarily denote lack of self-control. Despite the cynicism and incredulity of DID NRGI defenses, the experts in the field of psychology and law agree that there do exist genuine cases of dissociative amnesia and that the criminal culpability under these circumstances raises hard questions (Farrell, 2011, pp. 402-406). In cases in which the defendant pleads not guilty by reason of mental illness, the legal policy makers and the attorneys of these cases face great challenges in undertaking this defense. However, I believe that these debates must be had in order to assure justice and humane treatment. Despite the obstacles involved in controversial clinical and legal issues, the field must press onward at all times in an effort to fully understand DID and bolster reliability in forensic expert testimony. There does exist a very real danger in the concept of false positives and malingering defendants but the practice of justice is not aimed at perfection and instead is aimed at the ethical and rational management of human fa ctors. One compelling argument to move in this direction instead of ruling all DID expert testimony inadmissible is that psychology is an evolving science and constructs such as DID may see major revision as more research is performed (Take the changes from DSM-IV to DSM-5). As this slow process matures the legal world will need to understand the full picture of DID, the most effective forensic tools for detecting malingering in DID suspected defendants and the degree to which criminal responsibility is thought to apply given challenges to self-control and autonomy present in some, but not all DID cases. Similarly to the false or recovered memory debate involving children, DID is a nuanced condition involving vulnerable populations and disturbances of memory with a high susceptibility to malingering and influences of the culture, the professionals and the court process. The law must engage with these difficult problems and move the profession towards a deeper understanding of all factors involved in dissociative identity disorder as a part of due diligence and to preserve justice.

Evaluate the social and economic impacts of the ‘One Child’ Policy in China Essay

Evaluate the social and economic impacts of the ‘One Child’ Policy in China In the year 1979, China was suffering a severe increase in population, and because of this Deng Xiaoping (leader of the communist party of China) introduced China to an anti-natalist policy called the ‘One Child’ policy. An anti-natalist policy aims to decrease the crude birth rate and the total fertility rate in a country in order to slow the population growth . This policy generated many social and economical impacts and in this essay I will talk about the social advantages of the policy, the social disadvantages, the economical advantages and finally the economical disadvantages. Firstly, the ‘One Child’ policy has created social advantages in China, since the population growth rate decreased. Due to the fact that the ‘One Child’ policy restricts women from only having one child in urban areas (there are some exceptions, like twins, lived in a rural area, if your child died then you can have another), this slowed down the crude birth rate and the total fertility rate. If China’s population kept on growing at the same rate like it was before any policies were introduced they would have encountered problems with resources. Resources are limited and China only has a certain amount of land, food, natural resources and water. This policy lowered the pressure on the limited amounts of resources and enabled people to have enough food and water to have a good enough quality of life and not live in fright, that one-day there wont be enough food and water. Furthermore, if a couple follows this policy, they would be offered some incentives. These incentives include that they would have access to health services and the child would have an education . This is a great advantage because the child will have an education and can learn and develop as a person and hopefully have a higher chance of succeeding in life. Also, access to health services is a great benefit because some families wouldn’t be able to afford health services. It will make sure that the family will be healthy and hopefully live longer. Women will receive education about having a child and will receive free contraception. With this, we can say that the ‘One Child’ policy created social advantages to people living in China. Secondly, the ‘One child’ policy also has produced social disadvantages in  China, like a gender imbalance and other social problems. Only having one child in a family can create some social problems with the child. Individuals who grew up, as single children as a result of China’s policy were considerably less trustworthy, more risk-averse, less competitive, more pessimistic, and less conscientious individuals . Their social skills will be poor with other children since they have no siblings at home. The parents usually spoil the child since it’s the only child they have, this is how the name the ‘little emperors’ was created for an only child. Additionally, the male to female ratio has drastically leaded towards the male side. This is because parents prefer to have a boy rather than a girl because when the parents get older, they will have to depend on their son’s wife to take care of them. If they had a girl then they wouldn’t be able to move in with their daughter because the daughter will look after her husbands parents rather than her own parents. This has a created a gender imbalance (for every 6 boys born in China, there are 5 girls) in China and has caused many older men to have no partner due to the simple fact that there aren’t enough women for the amount of men. In addition, there are some cases where unwanted girls are abandoned or aborted even though it is illegal in China. These children will have to be adopted or go to an orphanage. Child trafficking is at a record high in China and for the purpose of exploitation, which is a human right violation. Since there is a fall in the crude birth rate and total fertility rate there is going to be a greater gap between the younger population and the ageing population, which will mean that China could become a ageing population instead of a stable population. As we can see, China’s ‘One Child’ policy has made many negative social impacts in China. Thirdly, economic advantages of the ‘One Child’ policy are seen in China with a clear economic growth in China. It costs quite a lot to raise one child and it’s not easy to raise another child and therefore families will save money by only having one child. It is also believed that the ‘One Child’ policy is benefitting the economic future of China because it aids to improve the living standards and saves a lot more resources as I said before. Furthermore, the policy also reduces unemployment in China because there will be more jobs available to people since there will be a decrease in population. This will allow most people to have a job and earn more money  and therefore their standards of living will be better. The ‘One Child’ policy has had some positive economic impacts on China and the living quality for the Chinese. Fourthly, the ‘One Child’ policy has generated negative economic impacts on China. Older generations are dependent on the younger generations. The one child that is economically active is going to need to take care of his/her parents. However, if the one child is unable to take care because they don’t have a job, his/her parents will then face a very tough end of their life with very few resources. Also if you do have more than one child then you will receive a fine of a certain amount (depends on which province you live in), which can affect the family. The ‘One Child’ policy has so far created these negative economic problems on China. In conclusion, the ‘One Child’ policy has generated positive and negative social and economical impacts. I think that the policy is doing what it should be doing to China’s population, which is lowering it and slowing down the growth rate. China would be close to 2 billion people right now if the policy wasn’t introduced in my opinion, instead of its current population 1.3 billion . Word Count: 1063 Bibliography allgirlsallowed (Director). (2011). Statistics About Gendercide and the One-Child Policy [Motion Picture]. Fozzard, H. (2011, May 18). One Child Policy Incentives: Support for the Family. Retrieved October 1, 2013, from shenzhenparty: www.shenzhenparty.com/abpo-one-child-policy-incentives-support-for-the-family Google. (2012). china’s current population. Retrieved October 1, 2013, from Google: https://www.google.ch/search q=china’s+current+population&rlz=1C5CHFA_enCH545CH546&oq=chinas+current+po&aqs=chrome.1.69i57j0l5.4406j0&sourceid=chrome&espvd=210&es_sm=91&ie=UTF-8 Guinness, P. (2011). Patterns and Change. Cambridge: Cambridge University Press. Monash. (2013, January 11). The effects of China’s One Child Policy on its children. Retrieved October 1, 2013, from monash.edu: http://www.monash.edu.au/news/show/the-effects-of-chinas-one-child-policy-on-its-children Schwarz, T. (2010, October 5). Anti-natalist Policies. Retrieved October 1, 2013, from Geography IBHL: http://zisgeography.wordpress.com/2010/10/05/anti-natalist-policies/

Equality, Diversity and Inclusion in Work with Children Essay

Inclusive practice is identifying and understanding any barriers that are stopping children from completing the activity. We have to make sure that whatever the child’s background they are able to fully join in with everything within the school. This will make the children feel valued and have a sense of belonging. Inclusion does not mean that we view each other the same or provide the same work, it is about making sure we are making adaptions to the activity instead of making a child do a completely different activity and make sure we are providing the same opportunities. We need to take on board and accept that the child is different. Medical model of Disability- The medical model is based on that children must adapt to the environment that exists, for example in my school there is down’s syndrome boy he attends all lessons, but he has a support worker who is helping him. We assume that the child will adapt to our atmosphere, this means that the boy will depend more and more of others to help him. Social Model of Disability- The social model is more about the school adapting things to suit the child, so they have more independence. Changing the physical environment, which could be ramps or lower shelves for children with disabilities to reach. Providing information such as symbols or sign language The curriculum can be modified with additional support or adjustments to assessments. Describe the features of an Inclusive Setting We often talk about the atmosphere of a school. This relates to a feeling that everyone in the school matters and all play their own part in school life. When entering my school I felt relaxed and excited about being able to volunteer at this school. The reception area was colourful and full of children’s work. The staff seemed friendly and made me feel welcome in their school. It is a clean, fresh and modern school. An inclusive setting is setting which uses a whole school approach to learning, working within a team. Where any barriers are found, strategies need to be used to remove them. When working with special education needs children it is important to focus on what they are good at rather then what they can’t do. So for example: Two children are sitting in their place in the classroom and they are running behind with copying the work from the board, they are sat in a position where they have their backs to the board. So to overcome this barrier I will ask to move them so they can see the board more clearly and catch up with the work. A school with inclusive practice will have the following features: * Barriers are recognised:  This could be from the parents, assessments, observations or staff noticing * Barriers will be removed or minimised: This can be done by arranging outside agencies to come in to the school and to change the environment for example ramp instead of steps * Pupils will be educated alongside their peers: A child who cannot do the work the class is doing should not be moved to a different room, they need to stay in the classroom and have more access to support or equipment that will help them. * Children are given the chance to use their own voice to air their views and opinions which will be listened to: They should be involved in what they need, asked what barriers to be removed which will help them and asked simple questions about how the activity went and if they enjoyed it. A good way of letting children have a voice is a school council or a radio station. * There will be clear policies and procedures: All policies and procedures will be reviewed regularly and made clear to all staff * Staff will receive regular training relating to inclusion: Staff members would be offered regular training when it comes to inclusion, diversity and equality of opportunities. * The school will work in partnership with stakeholders: These will be parents, staff members or other outside agencies * It will also work in partnership with other services: This will be speech therapist, doctors, health visitors, social services to make sure that children are given professional help. Case Study: Inclusive practice Sean has just qualified as a teaching assistant and has started his new post at a large primary school. It is his first week and so that he gets to know the school, staff and children, he has been asked to work alongside Kira, an experienced teaching assistant who has been at the school for a number of years. Sean joined Kira who was working with a group of 7 year old children making 3D models. Sean noticed one of the children, Jamie, sitting at the side just watching and asked where his model was. Kira’s reply was that because of his disability (cerebral palsy), Jamie had difficulty in using the tools and materials. She said that she asks him to read a book during the art and craft lesson. Suggest how Jamie might feel – Jamie would feel left out, upset and wandering why he is being left out. He might feel embarrassed or that he has done something wrong. Jamie could be bullied about the situation and children might leave him out during playtime etc. Loneliness and isolated could be another feeling he might experience. What message does this give to other children in the group-? Other children might get the impression that he can’t do anything and end up doing everything for him. They might think that he is stupid or start to leave the child out in activities as they have watched staff members doing it. The children might refuse to do the activity as Jamie is seen not doing it and they might start to bully Jamie. Which policies, codes and legislation Sean refer to when challenging the exclusive practice with Kira- Diversity, inclusion, equality, discrimination act but most of all every child matters Sean will support this group in future weeks. How can he ensure that Jamie is included? He could research more about the condition that Jamie has, to be able to have more knowledge and help improve his support towards him. He could help plan the lesson with activities that Jamie could be involved with. Also giving Jamie a voice and asking him what activities he is able to do or how they can change them. Educate the other children about cerebral palsy so they can help Jamie out. Describe how inclusion works in your own sector of the children’s workforce All staff who work with children must all have a common understanding of values and principles of inclusion. The way that these are put into practice will be different with each role within education and care of the children. The Early Years Foundation and National Curriculum give us clear guidance on an inclusive approach to learning and assessment. ‘Providers have a responsibility to promote positive attitudes to diversity and difference, so that every child is included and not disadvantaged’ This is a statement from Early Years foundation Stage about the duty of settings to meet the needs of all children in relation to their learning and development. The National Curriculum Inclusion statement states that schools must apply a whole- school method to both the national and wider curriculum and that school’s must: * Provide a curriculum which ensures active participation and achievement of all pupils * Recognise pupils entitlement to high- quality learning experiences * Meet the needs and interest of all pupils  * Recognise and overcome potential barriers to learning and assessment

Two Opposing Powers - 1619 Words

I recently read two articles concerning the topics of science and religion. Chet Raymo, author of Miracles and Explanations, offers insight on how science and religion are closely related while David Ludden, author of â€Å"Teaching Evolution at a Christian College†, declares that science and religion are too contradicting from one another and that people are unwilling to open their minds to new ideas once they have established their beliefs (Raymo Ludden, 2011). This is a topic that has had controversy surrounding it for an innumerable amount of years dating back to ancient times when the Catholic Church ruled Europe to present times where we have to decide if we want our children learning about Darwin’s theory of evolution because it might†¦show more content†¦Mr. Ludden closes by stating one strategy science teachers use to capture the interest of their students. He uses the analogy of a drug pusher giving away drugs for free until the client is hooked and then starts charging them for more. He states that this method doesn’t work because science doesn’t produce the high religion does and that at the end of the day it is up to the student to decide whether they want to accommodate science with their faith (Raymo Ludden, 2011, p. 702-704). Mr. Raymo uses a Rogerian style in his writing because he is trying to build common ground in his argument. He starts by talking about miracles and how we are taught fake stories when we are young. This is something majority of people can relate to. Then he explains how as we get older we acknowledge these miracles as lies because we disprove them scientifically. He also mentions that the concepts of science are miracles and based on that scientists form theories. So far his reasoning is logical. This helps his argument because more people will appeal to logical reasoning. 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